Individual
MISTY JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 SEVILLE RD, HURRICANE, WV 25526-9206
(304) 757-6805
Mailing address
300 SEVILLE RD, HURRICANE, WV 25526-9206
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002355
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341401834
DRIVERS LICENSE
NY
Enumeration date
08/23/2017
Last updated
08/23/2017
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