Provider Demographics
NPI:1578954053
Name:JONES, TERRI (PTA, ATC)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PTA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GARRISON RD
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2281
Mailing Address - Country:US
Mailing Address - Phone:215-796-2046
Mailing Address - Fax:
Practice Address - Street 1:3 GARRISON ROAD
Practice Address - Street 2:
Practice Address - City:IVYLAND
Practice Address - State:PA
Practice Address - Zip Code:18974
Practice Address - Country:US
Practice Address - Phone:215-796-2046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI001266225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant