Provider Demographics
NPI:1164053153
Name:AGAPAY, BYRON ETHAN GAMBOL (DC)
Entity Type:Individual
Prefix:DR
First Name:BYRON ETHAN
Middle Name:GAMBOL
Last Name:AGAPAY
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 1:503 COTTAGE LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7303
Mailing Address - Country:US
Mailing Address - Phone:808-781-2772
Mailing Address - Fax:
Practice Address - Street 1:8515 FALLS OF NEUSE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3513
Practice Address - Country:US
Practice Address - Phone:919-582-7057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor