Healthcare Provider Details

I. General information

NPI: 1427631605
Provider Name (Legal Business Name): FALISA D JONES LMT, CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7451 TOCCOA CIR
UNION CITY GA
30291-3452
US

IV. Provider business mailing address

7451 TOCCOA CIR
UNION CITY GA
30291-3452
US

V. Phone/Fax

Practice location:
  • Phone: 404-565-3034
  • Fax:
Mailing address:
  • Phone: 404-565-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT005207
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: