Provider Demographics
NPI:1083200968
Name:WALLINGFORD, JOY LYNN
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:LYNN
Last Name:WALLINGFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-3540
Mailing Address - Country:US
Mailing Address - Phone:740-703-2775
Mailing Address - Fax:
Practice Address - Street 1:784 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3540
Practice Address - Country:US
Practice Address - Phone:740-703-2775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty