Provider Demographics
NPI:1134419138
Name:JONES, KERRY WAYNE JR (P,T,)
Entity type:Individual
Prefix:MR
First Name:KERRY
Middle Name:WAYNE
Last Name:JONES
Suffix:JR
Gender:M
Credentials:P,T,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3397 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-6223
Mailing Address - Country:US
Mailing Address - Phone:325-676-5633
Mailing Address - Fax:325-676-8831
Practice Address - Street 1:3397 S 27TH
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6223
Practice Address - Country:US
Practice Address - Phone:325-676-5633
Practice Address - Fax:325-676-8831
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist