Provider Demographics
NPI:1356527394
Name:JONES, MARCIA LEIGH (LMT)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:LEIGH
Last Name:JONES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ASTATULA
Mailing Address - State:FL
Mailing Address - Zip Code:34705-9726
Mailing Address - Country:US
Mailing Address - Phone:352-223-9735
Mailing Address - Fax:
Practice Address - Street 1:17 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:ASTATULA
Practice Address - State:FL
Practice Address - Zip Code:34705-9726
Practice Address - Country:US
Practice Address - Phone:352-223-9735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA30044225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist