Provider Demographics
NPI:1497808786
Name:BYINGTON, BRAD ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:ALAN
Last Name:BYINGTON
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 1:15048 BEAR VALLEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-9235
Mailing Address - Country:US
Mailing Address - Phone:760-245-0259
Mailing Address - Fax:
Practice Address - Street 1:15048 BEAR VALLEY RD STE A
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-9235
Practice Address - Country:US
Practice Address - Phone:760-245-0259
Practice Address - Fax:760-952-2776
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 20534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor