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General NPI Number Information
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NPI Number | 1962805374
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Entity Type | Individual
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Provider Name | JESSICA SUZANNE JONES DPT
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Gender | Female
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 3660 GUION RD STE 120
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-1691
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Country | US
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Telephone | 317-329-7017
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Fax | 317-387-2362
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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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 |
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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 | 11189
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 11189
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License Number State | AZ
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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 | 05011617A
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License Number State | IN
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