Provider Demographics
NPI:1245757012
Name:JONES, HUNTER RIDDICK (RN, LMT)
Entity Type:Individual
Prefix:DR
First Name:HUNTER
Middle Name:RIDDICK
Last Name:JONES
Suffix:
Gender:M
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 JOHN ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-1463
Mailing Address - Country:US
Mailing Address - Phone:864-879-4004
Mailing Address - Fax:
Practice Address - Street 1:300 JOHN ST STE 3A
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1463
Practice Address - Country:US
Practice Address - Phone:864-879-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8038172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist