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General NPI Number Information
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NPI Number | 1487976262
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Entity Type | Organization
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Legal Business Name | BRYCE CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 119 GARDEN ST SUITE C
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City | PRESCOTT
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State | AZ
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Zip | 86305-2913
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Country | US
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Telephone | 928-771-2345
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Fax | 928-771-0951
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Provider Business Mailing Address
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Address Line | 119 GARDEN ST SUITE C
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City | PRESCOTT
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State | AZ
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Zip | 86305-2913
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Country | US
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Telephone | 928-771-2345
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Fax | 928-771-0951
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Authorized Official
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Title or Position | DOCTOR
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Name | JUSTIN BOYCE BRYCE
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Credential | D.C.
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Telephone | 928-771-2345
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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 | 6031
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License Number State | AZ
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