Provider Demographics
NPI:1487998779
Name:JONES, ZACHARY GEORGE (DPT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:GEORGE
Last Name:JONES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12311 PERRY HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:412-359-4646
Mailing Address - Fax:412-359-4533
Practice Address - Street 1:12311 PERRY HIGHWAY
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:412-359-4646
Practice Address - Fax:412-359-4533
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023444225100000X
SC6891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029762330001Medicaid
PA1029762330001Medicaid