MEDICARE: DONNA E JONES PHYSICAL THERAPIST

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	7648	TN

General Provider Information

NPI Number	:	1740380054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA E JONES PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	PO BOX 681478
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-1478
Country	:	US
Telephone Number	:	866-800-9147
Fax Number	:	615-591-6601

Provider Business Practice Location Address
First Line	:	1808 HAYNES ST
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37043-4547
Country	:	US
Telephone Number	:	931-906-4170
Fax Number	:	931-906-4173

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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