Provider Demographics
NPI:1417006040
Name:JONES, GREG T (DC)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:T
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:GREGORY
Other - Middle Name:THOMAS
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2360 W MONTE VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-9668
Mailing Address - Country:US
Mailing Address - Phone:209-668-3841
Mailing Address - Fax:209-250-2581
Practice Address - Street 1:2360 W MONTE VISTA AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-9668
Practice Address - Country:US
Practice Address - Phone:209-668-3841
Practice Address - Fax:209-250-2581
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0283830Medicare ID - Type Unspecified
CAU94610Medicare UPIN