Provider Demographics
NPI:1326272709
Name:JONES, KIMBERLY JO (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:JO
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:15 MECHANIC STREET
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16929
Mailing Address - Country:US
Mailing Address - Phone:607-329-8448
Mailing Address - Fax:
Practice Address - Street 1:15 MECHANIC STREET
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:PA
Practice Address - Zip Code:16929
Practice Address - Country:US
Practice Address - Phone:607-329-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011704111N00000X
PA010099111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor