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NPI 1366975484

NPI 1366975484 : ERIC A AYEN D.C. : BYRON, MN

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General NPI Number Information
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    NPI Number           |    1366975484
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC A AYEN D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/05/2017
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    Last Update Date     |    04/05/2017
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Provider Practice Location Address
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    Address Line         |    1067 4TH ST NE SUITE 200
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    City                 |    BYRON
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    State                |    MN
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    Zip                  |    55920-5002
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    Country              |    US
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    Telephone            |    507-358-9729
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1050 MAPLEBECK PL NE 
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    City                 |    BYRON
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    State                |    MN
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    Zip                  |    55920-1584
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    Country              |    US
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    Telephone            |    507-358-9729
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    6358
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    License Number State |    MN
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