Provider Demographics
NPI:1124349584
Name:JONES, AMBER (LMT)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 BIG TREE RD
Mailing Address - Street 2:U4
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-8641
Mailing Address - Country:US
Mailing Address - Phone:386-882-3744
Mailing Address - Fax:
Practice Address - Street 1:1600 BIG TREE RD
Practice Address - Street 2:U4
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-8641
Practice Address - Country:US
Practice Address - Phone:386-882-3744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48475225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist