Provider Demographics
NPI:1295336758
Name:JONES, NADIA ELIZABETH (LMT, CCT)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:LMT, CCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8215
Mailing Address - Country:US
Mailing Address - Phone:706-529-1149
Mailing Address - Fax:706-529-1149
Practice Address - Street 1:300 S HAMILTON ST
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8215
Practice Address - Country:US
Practice Address - Phone:706-529-1149
Practice Address - Fax:706-529-5279
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT010204225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty