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NPI 1851760920

NPI 1851760920 : KERI A JONES PT, DPT, LAT : LIVE OAK, TX

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General NPI Number Information
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    NPI Number           |    1851760920
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    Entity Type          |    Individual 
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    Provider Name        |    KERI A JONES PT, DPT, LAT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/18/2015
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    Last Update Date     |    09/18/2015
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Provider Practice Location Address
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    Address Line         |    12709 TOEPPERWEIN ROAD SUITE 101
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    City                 |    LIVE OAK
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    State                |    TX
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    Zip                  |    78233-3259
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    Country              |    US
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    Telephone            |    210-477-5151
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    Fax                  |    210-477-5152
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Provider Business Mailing Address
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    Address Line         |    12709 TOEPPERWEIN ROAD SUITE 101
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    City                 |    LIVE OAK
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    State                |    TX
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    Zip                  |    78233-3259
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    Country              |    US
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    Telephone            |    210-477-5151
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    Fax                  |    210-477-5152
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    1263697
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    License Number State |    TX
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