Provider Demographics
NPI:1205108289
Name:JONES, BRITTANY DANIELLE (PTA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:DANIELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:DANIELLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:PO BOX 932184
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-2184
Mailing Address - Country:US
Mailing Address - Phone:800-699-9395
Mailing Address - Fax:
Practice Address - Street 1:100 KIANA CT APT A
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-6767
Practice Address - Country:US
Practice Address - Phone:270-443-0681
Practice Address - Fax:270-442-7948
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010032130225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant