Provider Demographics
NPI:1194973552
Name:MOORE-JONES, ANGELA LEE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LEE
Last Name:MOORE-JONES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 BARSTOW ST NE APT 9204
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-2868
Mailing Address - Country:US
Mailing Address - Phone:859-494-5194
Mailing Address - Fax:
Practice Address - Street 1:8100 BARSTOW ST NE APT 9204
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-2868
Practice Address - Country:US
Practice Address - Phone:859-494-5194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004646225100000X
NM37572251P0200X
NMPT3757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics