MEDICARE: DR. KONNIE LAUREL JOYNER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1275	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831287051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KONNIE LAUREL JOYNER DC

Provider Business Mailing Address
First Line	:	1419B N HIGHLAND AVE
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-3467
Country	:	US
Telephone Number	:	731-422-4037
Fax Number	:	731-422-6449

Provider Business Practice Location Address
First Line	:	1419B N HIGHLAND AVE
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-3467
Country	:	US
Telephone Number	:	731-422-4037
Fax Number	:	731-422-6449

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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