Provider Demographics
NPI:1457429672
Name:JONES, TERRY L (DCINC)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:JONES
Suffix:
Gender:M
Credentials:DCINC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-2206
Mailing Address - Country:US
Mailing Address - Phone:937-773-9463
Mailing Address - Fax:937-773-6142
Practice Address - Street 1:210 N DOWNING ST
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356
Practice Address - Country:US
Practice Address - Phone:937-773-9463
Practice Address - Fax:937-773-6142
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311034182026OtherCARE SOURCE
OH0420600Medicaid
OH311034182026OtherCARE SOURCE
OH9249931Medicare PIN