Provider Demographics
NPI:1154582781
Name:JONES, BRAD HOWLAND (PT, CSCS)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:HOWLAND
Last Name:JONES
Suffix:
Gender:M
Credentials:PT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 E MISSION RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-8803
Mailing Address - Country:US
Mailing Address - Phone:760-891-0966
Mailing Address - Fax:760-891-0984
Practice Address - Street 1:456 E MISSION RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-8803
Practice Address - Country:US
Practice Address - Phone:760-891-0966
Practice Address - Fax:760-891-0984
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT275662251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic