Provider Demographics
NPI:1700666229
Name:JONES, NATHANIEL (DC, CMT)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:DC, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4757 THE GROVE DR STE 172
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-8426
Mailing Address - Country:US
Mailing Address - Phone:407-217-6308
Mailing Address - Fax:
Practice Address - Street 1:4757 THE GROVE DR STE 172
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-8426
Practice Address - Country:US
Practice Address - Phone:407-217-6308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor