Provider Demographics
NPI:1891934287
Name:JONES, MARTIN WILLIAM (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:WILLIAM
Last Name:JONES
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7272 E 37TH ST N APT 216
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-3207
Mailing Address - Country:US
Mailing Address - Phone:316-312-9432
Mailing Address - Fax:
Practice Address - Street 1:101 SUN AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4373
Practice Address - Country:US
Practice Address - Phone:785-832-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1702471225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist