Provider Demographics
NPI:1568640134
Name:JONES, RYAN CHARLES (DPT,CSCS)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:CHARLES
Last Name:JONES
Suffix:
Gender:M
Credentials:DPT,CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 W CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3774
Mailing Address - Country:US
Mailing Address - Phone:508-647-1633
Mailing Address - Fax:508-647-1634
Practice Address - Street 1:247 W CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3774
Practice Address - Country:US
Practice Address - Phone:508-647-1633
Practice Address - Fax:508-647-1634
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT-23787225100000X
MA19024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist