Provider Demographics
NPI:1932385820
Name:KING, JOY LUCINDA (LMT)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:LUCINDA
Last Name:KING
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:LUCINDA
Other - Last Name:SOWDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:6016 HENDON AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45431-1568
Mailing Address - Country:US
Mailing Address - Phone:937-478-8411
Mailing Address - Fax:
Practice Address - Street 1:3299 KEMP RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2550
Practice Address - Country:US
Practice Address - Phone:937-478-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLMT 33.015450225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist