Provider Demographics
NPI:1386056406
Name:JONES, BONNIE ANNETTE (PTA)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:ANNETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 EDINBURGH DR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-9013
Mailing Address - Country:US
Mailing Address - Phone:336-491-7931
Mailing Address - Fax:
Practice Address - Street 1:822 EDINBURGH DR
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-9013
Practice Address - Country:US
Practice Address - Phone:336-491-7931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA1190261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy