Provider Demographics
NPI:1629658299
Name:JONES, AUTUMN R (CPHT)
Entity Type:Individual
Prefix:MISS
First Name:AUTUMN
Middle Name:R
Last Name:JONES
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:OH
Mailing Address - Zip Code:43845-1003
Mailing Address - Country:US
Mailing Address - Phone:330-937-3400
Mailing Address - Fax:
Practice Address - Street 1:190 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1129
Practice Address - Country:US
Practice Address - Phone:740-295-5403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician