MEDICARE: MR. CORY D JONES PTA

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	225200000X	Physical Therapy Assistant	14-01432	KS

General Provider Information

NPI Number	:	1174604912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CORY D JONES PTA

Provider Business Mailing Address
First Line	:	4745 NW HUNTERS RIDGE CIR
Second Line	:	SUITE D
City	:	TOPEKA
State	:	KS
Zip	:	66618-2538
Country	:	US
Telephone Number	:	785-246-2300
Fax Number	:	785-246-2301

Provider Business Practice Location Address
First Line	:	4745 NW HUNTERS RIDGE CIR
Second Line	:	SUITE D
City	:	TOPEKA
State	:	KS
Zip	:	66618-2538
Country	:	US
Telephone Number	:	785-246-2300
Fax Number	:	785-246-2301

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2007

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