Provider Demographics
NPI:1083791032
Name:SALYER, EDDIE LEE (DC)
Entity Type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:LEE
Last Name:SALYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E BLACKJACK ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76446-2304
Mailing Address - Country:US
Mailing Address - Phone:254-445-2205
Mailing Address - Fax:254-445-4533
Practice Address - Street 1:200 E BLACKJACK ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:TX
Practice Address - Zip Code:76446-2304
Practice Address - Country:US
Practice Address - Phone:254-445-2205
Practice Address - Fax:254-445-4533
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6008OtherLICENSE NUMBER
TX603685Medicare ID - Type UnspecifiedMEDICARE NUMBER
TX635199Medicare UPIN