Provider Demographics
NPI:1639185531
Name:JONES, LUCY H (PT, GSC)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:H
Last Name:JONES
Suffix:
Gender:F
Credentials:PT, GSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 SPRING RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-5323
Mailing Address - Country:US
Mailing Address - Phone:913-706-8895
Mailing Address - Fax:856-258-6821
Practice Address - Street 1:1998 ROUTE 70 E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1834
Practice Address - Country:US
Practice Address - Phone:913-706-8895
Practice Address - Fax:856-424-2000
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02166225100000X
MO109248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO484853700Medicaid
KS4886955901Medicaid
KS4886955901Medicaid