Provider Demographics
NPI:1952698839
Name:JONES, MARY FINLAYSON
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:FINLAYSON
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1362 WOODLAND VIEW RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-7512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3511 BRASELTON HWY
Practice Address - Street 2:SUITE G2
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-5925
Practice Address - Country:US
Practice Address - Phone:404-367-2082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8915225100000X
GAPT011956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist