Provider Demographics
NPI:1043349665
Name:JONES, KIMBERLY P (LPTA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:P
Last Name:JONES
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21604
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0162
Mailing Address - Country:US
Mailing Address - Phone:540-725-5300
Mailing Address - Fax:540-725-5356
Practice Address - Street 1:1919 ELECTRIC RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1641
Practice Address - Country:US
Practice Address - Phone:540-725-5300
Practice Address - Fax:540-725-5356
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306602035225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant