Basic Information
| Provider Information | |||||||||
| NPI: | 1174031405 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOYNER | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | BENJAMIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 73 NEWTON RD UNIT 101 | ||||||||
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| City: | PLAISTOW | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038652440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783887272 | ||||||||
| FaxNumber: | 9783887373 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 BARRA RD UNIT 2 | ||||||||
| Address2: | |||||||||
| City: | BIDDEFORD | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040059459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072825386 | ||||||||
| FaxNumber: | 2079942546 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2018 | ||||||||
| LastUpdateDate: | 06/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | 225100000X | PT6239 | ME | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.