Individual
JONQUIL JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
2430 LAKE AVE, FORT WAYNE, IN 46805-5406
(260) 149-5899
Mailing address
2430 LAKE AVE, FORT WAYNE, IN 46805-5406
(260) 149-5899
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21505418
IN
Other
Enumeration date
02/18/2019
Last updated
02/18/2019
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