Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A6430 | NC |
NPI | 1013661909 |
---|---|
Provider Name | Lauren Ashely Jones |
First Address | Wilson, NC 27896-7625 |
Second Address | Goldsboro, NC 27534-1727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2022 |
Last Update Date | 09/02/2022 |