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NPI Code Detail

MEDICARE: DR. DAVID GERARD TRYBUS D.C.

MEDICARE:  DR. DAVID GERARD TRYBUS  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCE 005814MO

General Provider Information

NPI Number : 1043342066
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID GERARD TRYBUS D.C.
Provider Business Mailing Address
First Line : 1721 W ELFINDALE ST
Second Line : SUITE # 103
City : SPRINGFIELD
State : MO
Zip : 65807-1295
Country : US
Telephone Number : 417-832-0666
Fax Number :
Provider Business Practice Location Address
First Line : 1721 W ELFINDALE ST
Second Line : SUITE # 103
City : SPRINGFIELD
State : MO
Zip : 65807-1295
Country : US
Telephone Number : 417-832-0666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 07/08/2007

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Directions to “ DR. DAVID GERARD TRYBUS D.C.” Practice Location

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