=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699331561
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COBY JONES DPT PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2019
-----------------------------------------------------
Last Update Date | 09/23/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1378 MAIN ST
-----------------------------------------------------
City | CARBONDALE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81623-1840
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-208-2996
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2061 PANNIER CT
-----------------------------------------------------
City | GRAND JUNCTION
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81507-8803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-208-4417
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST AND OWNER
-----------------------------------------------------
Name | COBY JONES
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 970-208-2996
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------