Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 005061 | GA |
NPI | 1407073752 |
---|---|
Provider Name | Dr. Thomas P Jones |
First Address | Acworth, GA 30101-5819 |
Second Address | Acworth, GA 30101-5819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |