Provider Demographics
NPI:1306494513
Name:JONES, SIDNEY ALEXIS (PT, DPT)
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:ALEXIS
Last Name:JONES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E 33RD ST STE 105
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-6795
Mailing Address - Country:US
Mailing Address - Phone:410-366-0781
Mailing Address - Fax:410-366-0930
Practice Address - Street 1:1100 E 33RD ST STE 105
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-6795
Practice Address - Country:US
Practice Address - Phone:410-366-0781
Practice Address - Fax:410-366-0930
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist