Individual ProviderJonathan SongAcupuncturistOther Service ProvidersPractice Address6255 University Ave, Suite 202, Middleton, WI 53562-3485(608) 238-3333PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Song does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1336265495Provider TypeIndividualFull NameSong, JonathanTitleDr.CredentialOMD, MD, PHD, LACGenderMaleSole ProprietorNoEnumeration Date3/21/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address6255 University Ave, Suite 202, Middleton, WI 53562-3485Phone(608) 238-3333Fax(608) 238-3374Mailing LocationMailing Address6255 University Ave, Suite 202, Middleton, WI 53562-3485Phone(608) 238-3333Fax(608) 238-3374Provider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicense232Wisconsin