Provider Demographics
NPI:1487386728
Name:JONES, ILSA LUND (PT, DPT, CSCS)
Entity type:Individual
Prefix:DR
First Name:ILSA
Middle Name:LUND
Last Name:JONES
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 E THOMAS RD UNIT 1129
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6176
Mailing Address - Country:US
Mailing Address - Phone:330-858-0709
Mailing Address - Fax:
Practice Address - Street 1:8405 N PIMA CENTER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4669
Practice Address - Country:US
Practice Address - Phone:602-493-9361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-32410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist