Provider Demographics
NPI:1922082205
Name:JONES, DANIEL D (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:D
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 N MICHAEL ST
Mailing Address - Street 2:
Mailing Address - City:ST MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-1171
Mailing Address - Country:US
Mailing Address - Phone:814-834-3217
Mailing Address - Fax:814-834-5179
Practice Address - Street 1:129 N MICHAEL ST
Practice Address - Street 2:
Practice Address - City:ST MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-1171
Practice Address - Country:US
Practice Address - Phone:814-834-3217
Practice Address - Fax:814-834-5179
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 00259 L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009302320001Medicaid
PAT29257Medicare UPIN
PAJO121285Medicare ID - Type Unspecified