Provider Demographics
NPI:1730376153
Name:JONES, BO R (PTA)
Entity type:Individual
Prefix:MR
First Name:BO
Middle Name:R
Last Name:JONES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
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Mailing Address - Street 1:601 S PARK RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-0593
Mailing Address - Country:US
Mailing Address - Phone:509-921-7818
Mailing Address - Fax:509-891-0456
Practice Address - Street 1:601 S PARK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-0593
Practice Address - Country:US
Practice Address - Phone:509-921-7818
Practice Address - Fax:509-891-0456
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-30
Last Update Date:2007-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant