Provider Demographics
NPI:1306102819
Name:JONES, GREGORY TIMOTHY (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:TIMOTHY
Last Name:JONES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11282 MERRITT ST
Mailing Address - Street 2:
Mailing Address - City:CASTROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95012-3421
Mailing Address - Country:US
Mailing Address - Phone:831-633-4067
Mailing Address - Fax:831-633-4070
Practice Address - Street 1:11282 MERRITT ST
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95012-3421
Practice Address - Country:US
Practice Address - Phone:831-633-4067
Practice Address - Fax:831-633-4070
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor