Provider Demographics
NPI:1194297168
Name:JONES, JEAN G (PT)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:G
Last Name:JONES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 JAMES DOAK PKWY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-8305
Mailing Address - Country:US
Mailing Address - Phone:678-592-8679
Mailing Address - Fax:
Practice Address - Street 1:3004 DEXTER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3616
Practice Address - Country:US
Practice Address - Phone:365-530-2723
Practice Address - Fax:336-553-0651
Is Sole Proprietor?:No
Enumeration Date:2019-01-01
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP206552251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics