Provider Demographics
NPI:1184366841
Name:E JONES, JAMIE ELLIETTE (DPT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ELLIETTE
Last Name:E JONES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 7TH AVE S APT 108
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-4109
Mailing Address - Country:US
Mailing Address - Phone:218-556-9914
Mailing Address - Fax:
Practice Address - Street 1:1211 7TH AVE S APT 108
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4109
Practice Address - Country:US
Practice Address - Phone:218-556-9914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist