Provider Demographics
NPI:1669528600
Name:JONES, LATARSHA YVETTE (PT)
Entity type:Individual
Prefix:MRS
First Name:LATARSHA
Middle Name:YVETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4080 MEDLOCK PARK DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-2730
Mailing Address - Country:US
Mailing Address - Phone:770-761-1770
Mailing Address - Fax:866-552-8286
Practice Address - Street 1:501 PULLIAM ST SW
Practice Address - Street 2:SUITE 144
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2755
Practice Address - Country:US
Practice Address - Phone:404-522-2234
Practice Address - Fax:866-552-8286
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist