Provider Demographics
NPI:1598856254
Name:RYNES, JON JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:JOSEPH
Last Name:RYNES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S GERMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3803
Mailing Address - Country:US
Mailing Address - Phone:901-757-9000
Mailing Address - Fax:901-755-9605
Practice Address - Street 1:2121 S GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3803
Practice Address - Country:US
Practice Address - Phone:901-757-9000
Practice Address - Fax:901-755-9605
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001358111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3970478Medicare ID - Type Unspecified
TNU75495Medicare UPIN