Provider Demographics
NPI:1639649775
Name:RALPH JOYNER, DC,LLC
Entity Type:Organization
Organization Name:RALPH JOYNER, DC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS
Authorized Official - Phone:863-294-2000
Mailing Address - Street 1:546 AVENUE A NE
Mailing Address - Street 2:C/O MASSAGE AND SPINAL THERAPY OF WINTER HAVEN
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4753
Mailing Address - Country:US
Mailing Address - Phone:863-294-2000
Mailing Address - Fax:863-292-9697
Practice Address - Street 1:546 AVENUE A NE
Practice Address - Street 2:C/O MASSAGE AND SPINAL THERAPY OF WINTER HAVEN
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4753
Practice Address - Country:US
Practice Address - Phone:863-294-2000
Practice Address - Fax:863-292-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-02
Last Update Date:2018-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382161700Medicaid