Healthcare Provider Details

I. General information

NPI: 1932870037
Provider Name (Legal Business Name): JULIUS BYRD DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 MERRITT BLVD
DUNDALK MD
21222-2113
US

IV. Provider business mailing address

10 LIGHT ST UNIT 819
BALTIMORE MD
21202-1471
US

V. Phone/Fax

Practice location:
  • Phone: 410-285-0920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number04105
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: