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General NPI Number Information
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NPI Number | 1891934287
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Entity Type | Individual
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Provider Name | MARTIN WILLIAM JONES OTR/L
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Gender | Male
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 101 SUN AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4373
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Country | US
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Telephone | 785-832-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 7272 E 37TH ST N APT 216
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City | WICHITA
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State | KS
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Zip | 67226-3207
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Country | US
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Telephone | 316-312-9432
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1702471
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License Number State | KS
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