Healthcare Provider Details

I. General information

NPI: 1225850589
Provider Name (Legal Business Name): MARCUS D JONES ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 BOSTON POST RD
AMHERST NH
03031-2730
US

IV. Provider business mailing address

13 SPARROW DR
BARRINGTON NH
03825-5109
US

V. Phone/Fax

Practice location:
  • Phone: 603-673-9940
  • Fax:
Mailing address:
  • Phone: 252-529-0918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1525
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: