Provider Demographics
NPI:1710029244
Name:JONES, EDWARD DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:DEAN
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 1:103 MUSCADINE LN
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-7588
Mailing Address - Country:US
Mailing Address - Phone:865-947-8388
Mailing Address - Fax:864-947-2156
Practice Address - Street 1:729 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3153
Practice Address - Country:US
Practice Address - Phone:864-633-8733
Practice Address - Fax:864-947-2156
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor