MEDICARE: GARRETT JONES DPT

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	2018003422	MO

General Provider Information

NPI Number	:	1316446560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARRETT JONES DPT

Provider Business Mailing Address
First Line	:	14515 NORTH OUTER 40 RD
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-5791
Country	:	US
Telephone Number	:	314-434-8680
Fax Number	:

Provider Business Practice Location Address
First Line	:	3758 MONTICELLO PLZ
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63304-8613
Country	:	US
Telephone Number	:	636-329-0110
Fax Number	:

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

Provider Enumeration Date	:	02/02/2018
Last Update Date	:	02/02/2018

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