MEDICARE: JOSHUA JONES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1301352	TX

General Provider Information

NPI Number	:	1790346153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA JONES

Provider Business Mailing Address
First Line	:	521 N BRENTWOOD
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75904-7124
Country	:	US
Telephone Number	:	936-632-2639
Fax Number	:	936-639-4923

Provider Business Practice Location Address
First Line	:	521 N BRENTWOOD
Second Line	:
City	:	LUFKIN
State	:	TX
Zip	:	75904-7124
Country	:	US
Telephone Number	:	936-632-2639
Fax Number	:	936-639-4923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	06/26/2019

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Directions to “ JOSHUA JONES ” Practice Location

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