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Individual

KEVIN JONES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
110 VINEYARD CT, MONROE, LA 71202-7249
(318) 789-4354
Mailing address
110 VINEYARD CT, MONROE, LA 71202-7249
(318) 789-4354

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
050267467
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
475635677
FEDERAL TAX ID
LA
Enumeration date
12/01/2015
Last updated
12/01/2015
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