Provider Demographics
NPI:1114115326
Name:JONES, ALEMAYEHU TESFAYE (LAC,PTA)
Entity Type:Individual
Prefix:MR
First Name:ALEMAYEHU
Middle Name:TESFAYE
Last Name:JONES
Suffix:
Gender:M
Credentials:LAC,PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1224
Mailing Address - Country:US
Mailing Address - Phone:470-347-9868
Mailing Address - Fax:
Practice Address - Street 1:3908 LONGSTREET RD
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-1224
Practice Address - Country:US
Practice Address - Phone:910-908-7357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171100000X
TX2064720225200000X
GAPTA004438225200000X
152906171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant