Provider Demographics
NPI:1588701049
Name:JONES, PATSY RUTH (DC)
Entity type:Individual
Prefix:DR
First Name:PATSY
Middle Name:RUTH
Last Name:JONES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11330 HOMER RD
Mailing Address - Street 2:PO BOX 299
Mailing Address - City:LITCHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49252-0299
Mailing Address - Country:US
Mailing Address - Phone:517-542-2336
Mailing Address - Fax:
Practice Address - Street 1:11330 HOMER RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MI
Practice Address - Zip Code:49252-0299
Practice Address - Country:US
Practice Address - Phone:517-542-2336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOCO5023Medicare ID - Type UnspecifiedCHIROPRACTOR