Provider Demographics
NPI:1760771828
Name:JONES, RAYMOND DERWIN (CFTS)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:DERWIN
Last Name:JONES
Suffix:
Gender:M
Credentials:CFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 US HIGHWAY 70 E STE 202
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-8794
Mailing Address - Country:US
Mailing Address - Phone:855-965-6900
Mailing Address - Fax:919-965-6902
Practice Address - Street 1:3243 US HIGHWAY 70 E STE 202
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-8794
Practice Address - Country:US
Practice Address - Phone:855-965-6900
Practice Address - Fax:919-965-6902
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCFTS01245225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter