Provider Demographics
NPI:1649048273
Name:JONES, NAOMI (PTA, LMT)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PTA, LMT
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 SW PARKRIDGE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-9200
Mailing Address - Country:US
Mailing Address - Phone:580-830-7015
Mailing Address - Fax:
Practice Address - Street 1:1401 SW PARKRIDGE BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-9200
Practice Address - Country:US
Practice Address - Phone:580-830-7015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK193741225700000X
OK1746225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist