Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | MA59343 | FL |
NPI | 1164781654 |
---|---|
Provider Name | Garanne Jones |
First Address | Sanford, FL 32773-5494 |
Second Address | Sanford, FL 32773-5494 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2012 |
Last Update Date | 03/05/2012 |