Provider Demographics
NPI:1366685760
Name:JONES, JANEANE ASHLEE (LMT)
Entity Type:Individual
Prefix:
First Name:JANEANE
Middle Name:ASHLEE
Last Name:JONES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5953 WALDEN ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-9090
Mailing Address - Country:US
Mailing Address - Phone:479-856-5327
Mailing Address - Fax:
Practice Address - Street 1:1101 MALLARD PL
Practice Address - Street 2:SUITE A
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6806
Practice Address - Country:US
Practice Address - Phone:479-268-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4465225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist