Susan Caroline Jones, PT

Individual provider Active NPI Physical Therapist · Dexter, MO

NPI 1134498736 · NPPES record last updated Dec 28, 2011

Key facts

NPI
1134498736
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
115696 (MO)
Practice address
913 West Business Hwy 60
Dexter, MO 63841
Phone
(573) 624-6405
Fax
(573) 624-6314
NPI assigned
Dec 28, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
115696MOMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 115696 MO Yes

Addresses

Primary practice location

913 West Business Hwy 60
Dexter, MO 63841

Mailing address

913 West Business Hwy 60
Dexter, MO 63841
Phone (573) 624-6405

Other names

  • Susan Caroline Tennison Former name

Other providers in Dexter, MO

All providers in Dexter, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.