Healthcare Provider Details

I. General information

NPI: 1932380011
Provider Name (Legal Business Name): DIANE ALLISON JONES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2007
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7222 COMMERCE CENTER DR STE 100
COLORADO SPRINGS CO
80919-2225
US

IV. Provider business mailing address

703 N FOOTE AVE
COLORADO SPRINGS CO
80909-4505
US

V. Phone/Fax

Practice location:
  • Phone: 719-574-5562
  • Fax: 719-471-0445
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2631
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: