Provider Demographics
NPI:1295188746
Name:JONES, NATHAN ALEXANDER (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ALEXANDER
Last Name:JONES
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 JOHNNIE DODDS BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6130
Mailing Address - Country:US
Mailing Address - Phone:831-277-3840
Mailing Address - Fax:
Practice Address - Street 1:900 JOHNNIE DODDS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6130
Practice Address - Country:US
Practice Address - Phone:843-606-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8172225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist