Basic Information
| Provider Information | |||||||||
| NPI: | 1942655469 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | KATHLEEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 SPRINGHOUSE RD | ||||||||
| Address2: | |||||||||
| City: | KING OF PRUSSIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194061822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104200839 | ||||||||
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| Practice Location | |||||||||
| Address1: | 235 W LANCASTER AVE | ||||||||
| Address2: | |||||||||
| City: | DEVON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193331560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106888080 | ||||||||
| FaxNumber: | 8003518088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2016 | ||||||||
| LastUpdateDate: | 05/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0401X | OP006578 | VA | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
No ID Information.