Provider Demographics
NPI:1912980061
Name:JONES, CONSTANCE ELLEN (DC)
Entity type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:ELLEN
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 1:2701 NW 2ND AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6698
Mailing Address - Country:US
Mailing Address - Phone:561-392-3900
Mailing Address - Fax:561-392-3914
Practice Address - Street 1:2701 NW 2ND AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6698
Practice Address - Country:US
Practice Address - Phone:561-392-3900
Practice Address - Fax:561-392-3914
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3750111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88039OtherBLUE CROSS/BLUE SHIELD FL
FLU39981Medicare UPIN