Provider Demographics
NPI:1710401328
Name:JONES, DEZHELE
Entity Type:Individual
Prefix:
First Name:DEZHELE
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12108 BERMUDA CROSSROAD LN
Mailing Address - Street 2:STUDIO 22
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-2452
Mailing Address - Country:US
Mailing Address - Phone:804-721-7401
Mailing Address - Fax:
Practice Address - Street 1:12108 BERMUDA CROSSROAD LN STE 22
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-2452
Practice Address - Country:US
Practice Address - Phone:804-721-7401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management