Provider Demographics
NPI:1063249225
Name:MCVEY, JONATHAN LEE
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:LEE
Last Name:MCVEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 FACTORY RD # A
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:45710-9413
Mailing Address - Country:US
Mailing Address - Phone:740-447-4956
Mailing Address - Fax:
Practice Address - Street 1:20 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1630
Practice Address - Country:US
Practice Address - Phone:740-447-4957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTR193852253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care