Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 1868 | TX |
NPI | 1417450032 |
---|---|
Provider Name | Mr. Neil Joseph Jones |
First Address | Lubbock, TX 79407-2408 |
Second Address | Lubbock, TX 79407-2408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2018 |
Last Update Date | 09/03/2018 |