Provider Demographics
NPI:1477714962
Name:JONES, NANCY (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16180 PINE LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:48451-9093
Mailing Address - Country:US
Mailing Address - Phone:810-347-8334
Mailing Address - Fax:
Practice Address - Street 1:16180 PINE LAKE FOREST DR
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:MI
Practice Address - Zip Code:48451-9093
Practice Address - Country:US
Practice Address - Phone:810-347-8334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist