Provider Demographics
NPI:1083185573
Name:JONES, ARKAEL (LMT)
Entity Type:Individual
Prefix:MR
First Name:ARKAEL
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30344-5679
Mailing Address - Country:US
Mailing Address - Phone:770-656-9522
Mailing Address - Fax:
Practice Address - Street 1:220 SANDY SPRINGS CIR NE
Practice Address - Street 2:220 SANDY SPRINGS CIR NE 157-B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:770-656-9522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT009768225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty