Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 379 | SD |
NPI | 1003064767 |
---|---|
Provider Name | Mrs. Paula Jean Jones |
First Address | Sioux Falls, SD 57105-1016 |
Second Address | Sioux Falls, SD 57105-1020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2008 |
Last Update Date | 05/09/2008 |