MEDICARE: DR. THOMAS EDWARD JONES 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	PT.9691PT	SC

General Provider Information

NPI Number	:	1962069773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS EDWARD JONES DPT

Provider Business Mailing Address
First Line	:	PO BOX 114
Second Line	:
City	:	CREWE
State	:	VA
Zip	:	23930-0114
Country	:	US
Telephone Number	:	804-822-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	8465 DORCHESTER RD STE B
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-7307
Country	:	US
Telephone Number	:	843-767-3765
Fax Number	:

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

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	05/28/2019

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