Provider Demographics
NPI:1871175430
Name:RIOS, JOY LYNN
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:LYNN
Last Name:RIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 W 25TH ST STE 716
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-4131
Mailing Address - Country:US
Mailing Address - Phone:216-264-0841
Mailing Address - Fax:
Practice Address - Street 1:2012 W 25TH ST STE 716
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-4131
Practice Address - Country:US
Practice Address - Phone:216-264-0841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE