MEDICARE: BYNUM CHIROPRACTIC INC

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	13078	TX

General Provider Information

NPI Number	:	1710347398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BYNUM CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	4833 KELLER SPRINGS RD
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-5912
Country	:	US
Telephone Number	:	972-733-1014
Fax Number	:

Provider Business Practice Location Address
First Line	:	4833 KELLER SPRINGS RD
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-5912
Country	:	US
Telephone Number	:	972-733-1014
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID BYNUM
Credential	:	D.C.
Telephone Number	:	405-312-7669

Provider Enumeration Date	:	02/25/2016
Last Update Date	:	04/18/2024

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