Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA#13902 | FL |
NPI | 1013064484 |
---|---|
Provider Name | James R Jones |
First Address | Orlando, FL 32803-3005 |
Second Address | Winter Park, FL 32789-7102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 08/07/2007 |