MEDICARE: BRIAN BILYEA 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
1	111N00000X	Chiropractor	2301008333	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950E710040	OTHER	MI	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326058520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN BILYEA D.C.

Provider Business Mailing Address
First Line	:	2170 S MOREY RD
Second Line	:
City	:	LAKE CITY
State	:	MI
Zip	:	49651-9013
Country	:	US
Telephone Number	:	231-839-4263
Fax Number	:	231-839-4264

Provider Business Practice Location Address
First Line	:	2170 S MOREY RD
Second Line	:
City	:	LAKE CITY
State	:	MI
Zip	:	49651-9013
Country	:	US
Telephone Number	:	231-839-4263
Fax Number	:	231-839-4264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	12/09/2016

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