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NPI Code Detail

MEDICARE: MIKAYLA JONES

MEDICARE: MIKAYLA JONES
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
1225200000XPhysical Therapy AssistantA2709MN

General Provider Information

NPI Number : 1821788027
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAYLA JONES
Provider Business Mailing Address
First Line : 1128 SUMMIT AVE
Second Line :
City : SAINT PAUL PARK
State : MN
Zip : 55071-1442
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 275 PENN AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55405-1216
Country : US
Telephone Number : 612-377-4723
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2023
Last Update Date : 05/10/2023

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Directions to “ MIKAYLA JONES ” Practice Location

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