Provider Demographics
NPI:1588637276
Name:JONES, ELLEN CHRISTINE (MOTR, ATC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:CHRISTINE
Last Name:JONES
Suffix:
Gender:F
Credentials:MOTR, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 MAYNARD DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-4963
Mailing Address - Country:US
Mailing Address - Phone:317-513-7560
Mailing Address - Fax:
Practice Address - Street 1:3640 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-3569
Practice Address - Country:US
Practice Address - Phone:317-920-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001030A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer