Provider Demographics
NPI:1508800616
Name:JONES, LYNESSA ROSE (ATC,CPED)
Entity Type:Individual
Prefix:
First Name:LYNESSA
Middle Name:ROSE
Last Name:JONES
Suffix:
Gender:F
Credentials:ATC,CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 WHITE ST
Mailing Address - Street 2:#121
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-4952
Mailing Address - Country:US
Mailing Address - Phone:717-848-4800
Mailing Address - Fax:
Practice Address - Street 1:1855 POWDER MILL RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4723
Practice Address - Country:US
Practice Address - Phone:717-848-4800
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0032932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer