Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH10484 | FL |
NPI | 1164799953 |
---|---|
Provider Name | Dr. Joy Marie Henry |
First Address | Jacksonville, FL 32225-3531 |
Second Address | Jacksonville, FL 32225-3531 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2011 |
Last Update Date | 27/08/2013 |