Provider Demographics
NPI:1437457256
Name:JONES, COBY (DPT)
Entity Type:Individual
Prefix:
First Name:COBY
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 PANNIER CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-8803
Mailing Address - Country:US
Mailing Address - Phone:970-208-2996
Mailing Address - Fax:
Practice Address - Street 1:1378 MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-1840
Practice Address - Country:US
Practice Address - Phone:970-208-2996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CO0009358225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0009358OtherPHYSICAL THERAPY LICENSE
CO12330596OtherCAQH