Provider Demographics
NPI:1710526785
Name:JONES, KYLE LAWRENCE
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:LAWRENCE
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 1:12 MEDSTAR BLVD STE 255
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-1798
Mailing Address - Country:US
Mailing Address - Phone:410-877-8078
Mailing Address - Fax:
Practice Address - Street 1:12 MEDSTAR BLVD STE 255
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1798
Practice Address - Country:US
Practice Address - Phone:410-877-8078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology