Provider Demographics
NPI:1588283535
Name:JONES, STEFAN DANIEL (DPT)
Entity type:Individual
Prefix:
First Name:STEFAN
Middle Name:DANIEL
Last Name:JONES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-3013
Mailing Address - Country:US
Mailing Address - Phone:336-964-0209
Mailing Address - Fax:
Practice Address - Street 1:560 WINSTON RD STE B
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28642-2217
Practice Address - Country:US
Practice Address - Phone:336-964-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist