Provider Demographics
NPI:1861265472
Name:JONES, JEREMY JON (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:JON
Last Name:JONES
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 ASTER CT
Mailing Address - Street 2:
Mailing Address - City:BOURBON
Mailing Address - State:IN
Mailing Address - Zip Code:46504-1820
Mailing Address - Country:US
Mailing Address - Phone:574-780-7689
Mailing Address - Fax:
Practice Address - Street 1:2701 CHESTNUT STATION CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-6395
Practice Address - Country:US
Practice Address - Phone:800-335-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31008208A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist