Healthcare Provider Details

I. General information

NPI: 1447510706
Provider Name (Legal Business Name): CHRISTINE M JONES PT, DPT, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 N ERIE ST
MERCER PA
16137-1285
US

IV. Provider business mailing address

139 N ERIE ST
MERCER PA
16137-1285
US

V. Phone/Fax

Practice location:
  • Phone: 724-662-1776
  • Fax: 724-662-1858
Mailing address:
  • Phone: 724-662-1776
  • Fax: 724-662-1858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022478
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRTO000066
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: