Provider Demographics
NPI:1699860759
Name:JONES, MARCY E (DC)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-2867
Mailing Address - Country:US
Mailing Address - Phone:802-257-5177
Mailing Address - Fax:802-257-5178
Practice Address - Street 1:205 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-2867
Practice Address - Country:US
Practice Address - Phone:802-257-5177
Practice Address - Fax:802-257-5178
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT702111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTT25450Medicare UPIN
VTVN1518Medicare ID - Type Unspecified