Provider Demographics
NPI:1881904134
Name:JONES, MICHAEL E (CMT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 E ELDER ST
Mailing Address - Street 2:STE A
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-5000
Mailing Address - Country:US
Mailing Address - Phone:760-451-2188
Mailing Address - Fax:
Practice Address - Street 1:593 E ELDER ST
Practice Address - Street 2:STE A
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-5000
Practice Address - Country:US
Practice Address - Phone:760-451-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5324225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist