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General NPI Number Information
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NPI Number | 1336304492
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Entity Type | Organization
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Legal Business Name | BYMA CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 925 W WASHINGTON ST STE 107
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City | MARQUETTE
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State | MI
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Zip | 49855-4061
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Country | US
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Telephone | 906-227-0100
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Fax | 906-227-0200
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Provider Business Mailing Address
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Address Line | 925 W WASHINGTON ST STE 107
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City | MARQUETTE
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State | MI
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Zip | 49855-4061
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Country | US
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Telephone | 906-227-0100
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Fax | 906-227-0200
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. RANDALL JOHN BYMA
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Credential | D.C.
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Telephone | 906-227-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2301008366
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License Number State | MI
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