Healthcare Provider Details

I. General information

NPI: 1861304651
Provider Name (Legal Business Name): MR. DAMION JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 RYANS RUN
LANSDALE PA
19446-5578
US

IV. Provider business mailing address

2035 RYANS RUN
LANSDALE PA
19446-5578
US

V. Phone/Fax

Practice location:
  • Phone: 917-586-3702
  • Fax:
Mailing address:
  • Phone: 917-586-3702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number024515-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: