Healthcare Provider Details

I. General information

NPI: 1639396567
Provider Name (Legal Business Name): ALLEN R. JONES JR. PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 08/31/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 DENBIGH BLVD
NEWPORT NEWS VA
23608-3900
US

IV. Provider business mailing address

466 DENBIGH BLVD
NEWPORT NEWS VA
23608-3900
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-2932
  • Fax: 757-597-9514
Mailing address:
  • Phone: 757-873-2932
  • Fax: 757-597-9515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305003228
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: