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NPI Code Detail

MEDICARE: MR. MARTIN L JONES PT, CWS

MEDICARE:  MR. MARTIN L JONES  PT, CWS
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
1225100000XPhysical Therapist1070613TX

General Provider Information

NPI Number : 1306006606
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARTIN L JONES PT, CWS
Provider Business Mailing Address
First Line : PO BOX 531513
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75053-1513
Country : US
Telephone Number : 972-263-7042
Fax Number : 972-263-7046
Provider Business Practice Location Address
First Line : 504 N CARRIER PKWY
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75050-5428
Country : US
Telephone Number : 972-263-7042
Fax Number : 972-263-7046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2008
Last Update Date : 06/11/2008

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Directions to “ MR. MARTIN L JONES PT, CWS” Practice Location

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