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General NPI Number Information
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NPI Number | 1558562116
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Entity Type | Organization
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Legal Business Name | DR.ROBERT PYNE D.C.P.C.
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 10413 S ROBERTS RD
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City | PALOS HILLS
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State | IL
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Zip | 60465-1931
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Country | US
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Telephone | 708-599-9585
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Fax |
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Provider Business Mailing Address
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Address Line | 10413 S ROBERTS RD
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City | PALOS HILLS
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State | IL
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Zip | 60465-1931
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Country | US
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Telephone | 708-599-9585
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSCIAN
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Name | DR. ROBERT DAVID PYNE
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Credential | D.C.
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Telephone | 708-599-9585
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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 | 038005416
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License Number State | IL
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