Provider Demographics
NPI:1770261877
Name:JONES, CASSANDRA LYNN (PT)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN
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 1:142 LANE 201 BALL LK
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:IN
Mailing Address - Zip Code:46742-9654
Mailing Address - Country:US
Mailing Address - Phone:260-316-7139
Mailing Address - Fax:
Practice Address - Street 1:1675 W 7TH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-2087
Practice Address - Country:US
Practice Address - Phone:260-230-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO05003746A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist