MEDICARE: DR. RUDY AWAH JONES PT, 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	291743	CA
2	225100000X	Physical Therapist	10731	SC

General Provider Information

NPI Number	:	1700330602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUDY AWAH JONES PT, DPT

Provider Business Mailing Address
First Line	:	100 BREWSTER BLVD
Second Line	:
City	:	CAMP LEJEUNE
State	:	NC
Zip	:	28547-2575
Country	:	US
Telephone Number	:	910-450-4450
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 561 BOX 1877
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96310-0019
Country	:	US
Telephone Number	:	315-255-8156
Fax Number	:

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

Provider Enumeration Date	:	08/09/2016
Last Update Date	:	12/02/2025

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