Provider Demographics
NPI:1124729983
Name:JONES, DEBORAH COLLINS
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:COLLINS
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 EDGECREEK DR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-5306
Mailing Address - Country:US
Mailing Address - Phone:843-504-8970
Mailing Address - Fax:
Practice Address - Street 1:406 S 4TH ST
Practice Address - Street 2:
Practice Address - City:BASIN
Practice Address - State:WY
Practice Address - Zip Code:82410-5011
Practice Address - Country:US
Practice Address - Phone:307-562-9399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist