Provider Demographics
NPI:1306044698
Name:PYNE CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:PYNE CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:PYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-644-1792
Mailing Address - Street 1:65 BRYAN DR
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-9732
Mailing Address - Country:US
Mailing Address - Phone:302-644-1792
Mailing Address - Fax:
Practice Address - Street 1:17252 N VILLAGE MAIN BLVD
Practice Address - Street 2:SUITE #14-16
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-6292
Practice Address - Country:US
Practice Address - Phone:302-644-1792
Practice Address - Fax:302-644-1793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-000572111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEU96138Medicare UPIN
DEG01270Medicare ID - Type UnspecifiedGROUP MEDICARE #