Healthcare Provider Details

I. General information

NPI: 1992056832
Provider Name (Legal Business Name): ELIZABETH G JONES ATC, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2012
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9965 W BADEN DR
LITTLETON CO
80127-5914
US

IV. Provider business mailing address

9965 W BADEN DR
LITTLETON CO
80127-5914
US

V. Phone/Fax

Practice location:
  • Phone: 303-947-4783
  • Fax:
Mailing address:
  • Phone: 303-947-4783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT.0000862
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0023096
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: