Provider Demographics
NPI:1467769109
Name:JONES, SPENCER BURNETT
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:BURNETT
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 S 32ND ST W STE 4
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6887
Mailing Address - Country:US
Mailing Address - Phone:406-969-2468
Mailing Address - Fax:
Practice Address - Street 1:182 S 32ND ST W STE 4
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6887
Practice Address - Country:US
Practice Address - Phone:406-696-2468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1236111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor