Provider Demographics
NPI:1134281033
Name:JONES, SUSAN ELIZABETH (DC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 6TH AVE EAST
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5063
Mailing Address - Country:US
Mailing Address - Phone:406-755-5557
Mailing Address - Fax:406-755-5534
Practice Address - Street 1:38 EAST WASHINGTON ST
Practice Address - Street 2:SUITE #1
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3974
Practice Address - Country:US
Practice Address - Phone:406-755-5557
Practice Address - Fax:406-755-5534
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDC953111N00000X
CA11456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT40113OtherBLUE CROSS BLUE SHIELD