Provider Demographics
NPI:1124195706
Name:BYMERS, BRIAN CON (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CON
Last Name:BYMERS
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 1:507 N NOKOMIS ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2352
Mailing Address - Country:US
Mailing Address - Phone:320-762-2639
Mailing Address - Fax:320-762-2650
Practice Address - Street 1:507 N NOKOMIS ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2352
Practice Address - Country:US
Practice Address - Phone:320-762-2639
Practice Address - Fax:320-762-2650
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4167111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN494R7BYOtherBLUECROSS BLUESHIELD
MNP000233138OtherRAILROAD MEIDCARE
MNP000233138OtherRAILROAD MEIDCARE