Healthcare Provider Details

I. General information

NPI: 1558561357
Provider Name (Legal Business Name): DR. JAMES BYERS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 COMMERCE BLVD
MOUND MN
55364-1447
US

IV. Provider business mailing address

2365 COMMERCE BLVD
MOUND MN
55364-1447
US

V. Phone/Fax

Practice location:
  • Phone: 952-472-3434
  • Fax: 952-472-7205
Mailing address:
  • Phone: 952-472-3434
  • Fax: 952-472-7205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2820
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: