Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | P14210 | NC |
NPI | 1275182982 |
---|---|
Provider Name | Dr. Philip Jones |
First Address | Yanceyville, NC 27379-8789 |
Second Address | Yanceyville, NC 27379-8789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2019 |
Last Update Date | 05/09/2019 |