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General NPI Number Information
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NPI Number | 1477943470
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Entity Type | Individual
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Provider Name | MINDY LYNN JONES PTA
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Gender | Female
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 3844 11TH ST SW
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City | CANTON
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State | OH
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Zip | 44710-1492
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Country | US
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Telephone | 419-217-1012
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Fax |
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Provider Business Mailing Address
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Address Line | 3247 FRESNO RD NW
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City | CARROLLTON
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State | OH
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Zip | 44615-9211
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Country | US
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Telephone | 419-217-1012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PTA.02928
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License Number State | OH
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