Provider Demographics
NPI:1699873224
Name:YONCE, JOSEPH BOUKNIGHT JR (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BOUKNIGHT
Last Name:YONCE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JOJO
Other - Middle Name:
Other - Last Name:YONCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-0324
Mailing Address - Country:US
Mailing Address - Phone:864-316-2859
Mailing Address - Fax:864-457-7421
Practice Address - Street 1:13061 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:SC
Practice Address - Zip Code:29349-7687
Practice Address - Country:US
Practice Address - Phone:864-316-2859
Practice Address - Fax:864-457-7421
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2305Medicaid
U872020281Medicare PIN
SCCH2305Medicaid