Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A01840 | KY |
NPI | 1003956392 |
---|---|
Provider Name | Melissa Ann Jones |
First Address | Williamsburg, KY 40769-0239 |
Second Address | Williamsburg, KY 40769-1214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |