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General NPI Number Information
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NPI Number | 1588353007
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Entity Type | Individual
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Provider Name | ANTWAN JONES PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 2800 LAWRENCEVILLE SUWANEE RD
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City | SUWANEE
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State | GA
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Zip | 30024-2531
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Country | US
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Telephone | 678-926-3868
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Fax |
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Provider Business Mailing Address
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Address Line | 8927 LAVERGNE AVE APT 1B
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City | SKOKIE
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State | IL
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Zip | 60077-1648
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Country | US
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Telephone | 312-933-3373
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT303292
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License Number State | CA
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