Provider Demographics
NPI:1144416736
Name:JOYNER THERAPY SERVICES
Entity Type:Organization
Organization Name:JOYNER THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ADM
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-998-9894
Mailing Address - Street 1:607 S COMMERCIAL ST
Mailing Address - Street 2:SUTIE B
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-2345
Mailing Address - Country:US
Mailing Address - Phone:618-252-7171
Mailing Address - Fax:618-252-7272
Practice Address - Street 1:2907 WILLIAMSON COUNTY PKWY
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5256
Practice Address - Country:US
Practice Address - Phone:618-998-9894
Practice Address - Fax:618-998-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212384Medicare PIN
IL212392Medicare PIN