Provider Demographics
NPI:1487072526
Name:JONES, MARY CAITLIN (DPT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CAITLIN
Last Name:JONES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:37 BODINE ST
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-8206
Mailing Address - Country:US
Mailing Address - Phone:570-439-3132
Mailing Address - Fax:
Practice Address - Street 1:100 PLAZA LN
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901
Practice Address - Country:US
Practice Address - Phone:570-948-2050
Practice Address - Fax:570-984-2055
Is Sole Proprietor?:No
Enumeration Date:2014-04-05
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13951225100000X
PAPT022267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist