Healthcare Provider Details

I. General information

NPI: 1477473213
Provider Name (Legal Business Name): IAN J PHYSICAL THERAPY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 VAN BUREN ST APT 402
HOLLYWOOD FL
33020-5012
US

IV. Provider business mailing address

1900 VAN BUREN ST APT 402
HOLLYWOOD FL
33020-5012
US

V. Phone/Fax

Practice location:
  • Phone: 786-609-8643
  • Fax:
Mailing address:
  • Phone: 786-609-8643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. IAN BARRET JONES
Title or Position: PRESIDENT
Credential: PT, DPT
Phone: 786-609-8643