Provider Demographics
NPI:1083725683
Name:JONES, JAMY ANN (PT)
Entity Type:Individual
Prefix:
First Name:JAMY
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N HARRISON AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-2378
Mailing Address - Country:US
Mailing Address - Phone:605-224-8415
Mailing Address - Fax:605-224-8457
Practice Address - Street 1:1601 N HARRISON AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-2378
Practice Address - Country:US
Practice Address - Phone:605-224-8415
Practice Address - Fax:605-224-8457
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0679225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5831960Medicaid
SD5831960Medicaid