Healthcare Provider Details

I. General information

NPI: 1083601967
Provider Name (Legal Business Name): DEB JONES THERAPIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 GUSDORF RD SUITE G
TAOS NM
87571-6294
US

IV. Provider business mailing address

1337 GUSDORF RD SUITE G
TAOS NM
87571-6294
US

V. Phone/Fax

Practice location:
  • Phone: 575-758-4337
  • Fax: 575-751-1890
Mailing address:
  • Phone: 575-758-4337
  • Fax: 575-751-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number888
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. J. MICHAEL JONES
Title or Position: OFFICE MANAGER
Credential:
Phone: 575-758-4337