Provider Demographics
NPI:1336304492
Name:BYMA CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:BYMA CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BYMA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-227-0100
Mailing Address - Street 1:925 W WASHINGTON ST
Mailing Address - Street 2:STE 107
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4061
Mailing Address - Country:US
Mailing Address - Phone:906-227-0100
Mailing Address - Fax:906-227-0200
Practice Address - Street 1:925 W WASHINGTON ST
Practice Address - Street 2:STE 107
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4061
Practice Address - Country:US
Practice Address - Phone:906-227-0100
Practice Address - Fax:906-227-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008366261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center