Provider Demographics
NPI:1275060626
Name:JONES, GABRIELLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 RIVERTON DR
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-7437
Mailing Address - Country:US
Mailing Address - Phone:404-784-6703
Mailing Address - Fax:
Practice Address - Street 1:2500 RIVERTON DR
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-7437
Practice Address - Country:US
Practice Address - Phone:404-784-6703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2022-07-21
Deactivation Date:2018-03-07
Deactivation Code:
Reactivation Date:2019-01-30
Provider Licenses
StateLicense IDTaxonomies
GAPT009996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist