Provider Demographics
NPI:1023204120
Name:JONES, IRVIN DENNIS (DC)
Entity Type:Individual
Prefix:DR
First Name:IRVIN
Middle Name:DENNIS
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3691 PARK AVE
Mailing Address - Street 2:SUITE#6
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4783
Mailing Address - Country:US
Mailing Address - Phone:443-642-8420
Mailing Address - Fax:410-203-2830
Practice Address - Street 1:3691 PARK AVE
Practice Address - Street 2:SUITE#6
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4783
Practice Address - Country:US
Practice Address - Phone:443-642-8420
Practice Address - Fax:410-203-2830
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor