Provider Demographics
NPI:1609864032
Name:JONES, ANGELA SMITH (PT)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SMITH
Last Name:JONES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 FOX RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-8911
Mailing Address - Country:US
Mailing Address - Phone:336-906-2007
Mailing Address - Fax:336-857-5750
Practice Address - Street 1:2650 FOX RIDGE RD
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27205-8911
Practice Address - Country:US
Practice Address - Phone:336-906-2007
Practice Address - Fax:336-857-5750
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2506919Medicare ID - Type Unspecified