Provider Demographics
NPI:1477718526
Name:BOMAR-HYONG, ALLISON L (DC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:L
Last Name:BOMAR-HYONG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 W REX RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3866
Mailing Address - Country:US
Mailing Address - Phone:901-683-5971
Mailing Address - Fax:901-683-7336
Practice Address - Street 1:1069 W REX RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3866
Practice Address - Country:US
Practice Address - Phone:901-683-5971
Practice Address - Fax:901-683-5278
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC2105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor