MEDICARE: MR. SETH ANDREW JONES P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1214903	TX

General Provider Information

NPI Number	:	1033482898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SETH ANDREW JONES P.T.

Provider Business Mailing Address
First Line	:	PO BOX 29
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75483-0029
Country	:	US
Telephone Number	:	903-885-9906
Fax Number	:	903-438-9636

Provider Business Practice Location Address
First Line	:	1129 INDUSTRIAL DR E
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-3326
Country	:	US
Telephone Number	:	903-885-9906
Fax Number	:	903-438-9636

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2012
Last Update Date	:	02/09/2012

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