MEDICARE: JOY CHIROPRACTIC CLINIC, INC.

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	2050	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	103I353476	OTHER	TN	MEDICARE PTAN

General Provider Information

NPI Number	:	1003236241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOY CHIROPRACTIC CLINIC, INC.

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

Provider Business Practice Location Address
First Line	:	9413 APISON PIKE
Second Line	:	SUITE 122
City	:	COLLEGE DALE
State	:	TN
Zip	:	37363-8661
Country	:	US
Telephone Number	:	423-298-1488
Fax Number	:	423-531-4123

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOY-LYNN MARIE NORRIS
Credential	:	D.C.
Telephone Number	:	423-298-1488

Provider Enumeration Date	:	04/25/2014
Last Update Date	:	04/25/2014

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