Provider Demographics
NPI:1548793342
Name:JONES, JAMEL (MS, ATC)
Entity Type:Individual
Prefix:
First Name:JAMEL
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 W GIRARD AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1122
Mailing Address - Country:US
Mailing Address - Phone:860-995-9654
Mailing Address - Fax:
Practice Address - Street 1:3002 W GIRARD AVE
Practice Address - Street 2:APT 1
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-1122
Practice Address - Country:US
Practice Address - Phone:860-995-9654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0053352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer