Provider Demographics
NPI:1336258532
Name:JONES, KATHERINE LYNN (PT ATC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:PT ATC
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT ATC
Mailing Address - Street 1:249 WEST 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452
Mailing Address - Country:US
Mailing Address - Phone:304-269-8097
Mailing Address - Fax:304-269-8187
Practice Address - Street 1:249 WEST 2ND STREET
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452
Practice Address - Country:US
Practice Address - Phone:304-269-8097
Practice Address - Fax:304-269-8187
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
WV001434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist