=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124010368
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JONES PHYSICAL THERAPY PLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2005
-----------------------------------------------------
Last Update Date | 11/07/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1425 N MAIN ST
-----------------------------------------------------
City | HARRISON
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72601-2214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-741-4500
-----------------------------------------------------
Fax | 870-741-4507
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1425 N MAIN ST
-----------------------------------------------------
City | HARRISON
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72601-2214
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-741-4500
-----------------------------------------------------
Fax | 870-741-4507
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST / OWNER
-----------------------------------------------------
Name | MARCUS SHAWN JONES
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 870-741-4500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------