Provider Demographics
NPI:1376923383
Name:JONES, JOHN AUSTIN (ATC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:AUSTIN
Last Name:JONES
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 W WESTLAWN CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-7360
Mailing Address - Country:US
Mailing Address - Phone:620-218-1904
Mailing Address - Fax:
Practice Address - Street 1:8609 W WESTLAWN CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-7360
Practice Address - Country:US
Practice Address - Phone:620-218-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-007242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer