Provider Demographics
NPI:1114396561
Name:JONES, ALICIA (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:MARQUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT ATC
Mailing Address - Street 1:1055 ADAMS CIR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1820
Mailing Address - Country:US
Mailing Address - Phone:720-998-0554
Mailing Address - Fax:303-446-2201
Practice Address - Street 1:1055 ADAMS CIR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1820
Practice Address - Country:US
Practice Address - Phone:720-998-0554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013568225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist