1003236241 NPI number — JOY CHIROPRACTIC CLINIC, INC.

Table of content: AMANDA BETH SETLAK LMHP AND LP (NPI 1578729927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003236241 NPI number — JOY CHIROPRACTIC CLINIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOY CHIROPRACTIC CLINIC, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003236241
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9429 CHERI BETH CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OOLTEWAH
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37363-8980
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-298-1488
Provider Business Mailing Address Fax Number:
423-531-4123

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9413 APISON PIKE
Provider Second Line Business Practice Location Address:
SUITE 122
Provider Business Practice Location Address City Name:
COLLEGE DALE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37363-8661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-298-1488
Provider Business Practice Location Address Fax Number:
423-531-4123
Provider Enumeration Date:
04/25/2014

Additional Information

Authorized Official

Authorized Official Last Name:
NORRIS
Authorized Official First Name:
JOY-LYNN
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
423-298-1488

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2050 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 103I353476 . This is a "MEDICARE PTAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com