Provider Demographics
NPI:1114125960
Name:JOINER, DANA MICHELLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MICHELLE
Last Name:JOINER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6315 PARK HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-8627
Mailing Address - Country:US
Mailing Address - Phone:815-654-7924
Mailing Address - Fax:815-395-1382
Practice Address - Street 1:1160 N MULFORD RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-3883
Practice Address - Country:US
Practice Address - Phone:815-395-1452
Practice Address - Fax:815-227-1501
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070007931225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist