Provider Demographics
NPI:1730661273
Name:JONES, JONI WATKINS (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:WATKINS
Last Name:JONES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 DENNEY RD
Mailing Address - Street 2:
Mailing Address - City:CATAULA
Mailing Address - State:GA
Mailing Address - Zip Code:31804-3507
Mailing Address - Country:US
Mailing Address - Phone:706-570-2498
Mailing Address - Fax:
Practice Address - Street 1:353 DENNEY RD
Practice Address - Street 2:
Practice Address - City:CATAULA
Practice Address - State:GA
Practice Address - Zip Code:31804-3507
Practice Address - Country:US
Practice Address - Phone:706-570-2498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA815043225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA$$$$$$$$$OtherTAX ID