MEDICARE: LYNNETTE S 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	19402816	IA
2	225100000X	Physical Therapist	070012026	IL

General Provider Information

NPI Number	:	1578559266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNETTE S JONES PT

Provider Business Mailing Address
First Line	:	850 43RD AVE STE 100
Second Line	:
City	:	MOLINE
State	:	IL
Zip	:	61265-8401
Country	:	US
Telephone Number	:	309-743-2070
Fax Number	:	309-743-2073

Provider Business Practice Location Address
First Line	:	1121 N 5TH ST
Second Line	:
City	:	SAVANNA
State	:	IL
Zip	:	61074-9732
Country	:	US
Telephone Number	:	815-273-7049
Fax Number	:	815-273-2575

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

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	10/05/2011

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Directions to “ LYNNETTE S JONES PT” Practice Location

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