MEDICARE: HB HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	08002490A	IN

General Provider Information

NPI Number	:	1700181039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HB HEALTH, LLC

Provider Business Mailing Address
First Line	:	6215 COVINGTON RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7311
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6215 COVINGTON RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7311
Country	:	US
Telephone Number	:	260-414-4257
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TROY BENJAMIN BYALL
Credential	:	D.C.
Telephone Number	:	260-414-4257

Provider Enumeration Date	:	01/18/2011
Last Update Date	:	01/18/2011

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