Provider Demographics
NPI:1790138899
Name:JOURNEY TO HARMONY PHYSICAL THERAPY
Entity Type:Organization
Organization Name:JOURNEY TO HARMONY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:IVORY
Authorized Official - Middle Name:KEONA
Authorized Official - Last Name:JONES-JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT
Authorized Official - Phone:904-536-7262
Mailing Address - Street 1:219 FLAMINGO DR
Mailing Address - Street 2:#3312
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-7001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5232 MOON SHELL DR
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-3522
Practice Address - Country:US
Practice Address - Phone:904-536-7262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT25953261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy