MEDICARE: HALEY JONES PT

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	P10173	NC

General Provider Information

NPI Number	:	1437691813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY JONES PT

Provider Business Mailing Address
First Line	:	25 N HAMPSTEAD VILLAGE DR
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-3932
Country	:	US
Telephone Number	:	910-270-6026
Fax Number	:	910-270-6028

Provider Business Practice Location Address
First Line	:	25 N HAMPSTEAD VILLAGE DR
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-3932
Country	:	US
Telephone Number	:	910-270-6026
Fax Number	:	910-270-6028

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

Provider Enumeration Date	:	11/16/2016
Last Update Date	:	11/16/2016

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Directions to “ HALEY JONES PT” Practice Location

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