Provider Demographics
NPI:1467484964
Name:BYRNE, WILBERT ALLAN (CHIROPRACTOR)
Entity Type:Individual
Prefix:
First Name:WILBERT
Middle Name:ALLAN
Last Name:BYRNE
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8595 BEECHMONT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4783
Mailing Address - Country:US
Mailing Address - Phone:513-232-5090
Mailing Address - Fax:513-232-5090
Practice Address - Street 1:8595 BEECHMONT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4783
Practice Address - Country:US
Practice Address - Phone:513-232-5090
Practice Address - Fax:513-232-5090
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
311374639Medicare UPIN
OHBYO682601Medicare ID - Type Unspecified