Individual
MICHAEL EDWARD JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
463 ASHLEY RIDGE BLVD STE 100, SHREVEPORT, LA 71106-7231
(318) 671-8772
(318) 671-8776
Mailing address
463 ASHLEY RIDGE BLVD STE 100, SHREVEPORT, LA 71106-7231
(318) 671-8772
(318) 671-8776
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01597
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01597
STATE LICENSE
LA
Enumeration date
05/21/2007
Last updated
07/08/2007
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