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General NPI Number Information
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NPI Number | 1508630740
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Entity Type | Organization
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Legal Business Name | BAYSHORE CHIRO PC
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 32650 SR 20 STE D101
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City | OAK HARBOR
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State | WA
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Zip | 98277
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Country | US
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Telephone | 360-675-1066
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Fax |
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Provider Business Mailing Address
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Address Line | 32650 SR 20 STE D101
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City | OAK HARBOR
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State | WA
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Zip | 98277
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Country | US
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Telephone | 360-675-1066
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Fax |
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Authorized Official
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Title or Position | MANAGER/DOCTOR
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Name | MAXIMILIAN BICOFF
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Credential | DC
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Telephone | 425-229-7232
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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 |
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License Number State |
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