MEDICARE: PROF. SCOT ALAN JONES P.T.

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	04662	LA

General Provider Information

NPI Number	:	1881668705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. SCOT ALAN JONES P.T.

Provider Business Mailing Address
First Line	:	PO BOX 52396
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-2396
Country	:	US
Telephone Number	:	337-233-8080
Fax Number	:	337-237-1623

Provider Business Practice Location Address
First Line	:	201 W GLORIA SWITCH RD
Second Line	:	SUITE H
City	:	LAFAYETTE
State	:	LA
Zip	:	70507-2590
Country	:	US
Telephone Number	:	337-233-8080
Fax Number	:	337-237-1623

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/05/2011

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