Provider Demographics
NPI:1962788158
Name:JONES, RICHARD M (MS, ATC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:JONES
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Gender:M
Credentials:MS, ATC
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Mailing Address - Street 1:361 BIENTERRA TRAIL #8
Mailing Address - Street 2:ATTN: ATHLETIC TRAINER
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107
Mailing Address - Country:US
Mailing Address - Phone:815-489-8298
Mailing Address - Fax:815-380-6423
Practice Address - Street 1:300 ELM ST
Practice Address - Street 2:ATTN: ATHLETIC TRAINER
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61101-1238
Practice Address - Country:US
Practice Address - Phone:815-489-8298
Practice Address - Fax:815-380-6423
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2015-02-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer