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General NPI Number Information
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NPI Number | 1700250701
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Entity Type | Organization
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Legal Business Name | JONES ELITE ATHLETES LLC
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Dates
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Enumeration Date | 11/14/2015
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 3209 PREMIER DR SUITE 109
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City | PLANO
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State | TX
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Zip | 75075-2355
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Country | US
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Telephone | 972-265-9402
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Fax | 972-767-4003
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Provider Business Mailing Address
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Address Line | 3209 PREMIER DR SUITE 109
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City | PLANO
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State | TX
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Zip | 75075-2355
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST AND OWNER
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Name | DR. JACKLEEN W JONES
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Credential | P.T., D.P.T.
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Telephone | 732-429-2102
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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 | 1243887
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License Number State | TX
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