Provider Demographics
NPI:1720350952
Name:JONES, JOEL HUNTINGTON (LMT)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:HUNTINGTON
Last Name:JONES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5043 DIERKER RD
Mailing Address - Street 2:APARTMENT A1
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-5269
Mailing Address - Country:US
Mailing Address - Phone:740-361-9841
Mailing Address - Fax:
Practice Address - Street 1:1560 FISHINGER RD
Practice Address - Street 2:SUITE 140
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2108
Practice Address - Country:US
Practice Address - Phone:614-451-7246
Practice Address - Fax:614-451-7248
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.016549225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist