Provider Demographics
NPI:1578059234
Name:BYERLY, BRYAN JAMES
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:JAMES
Last Name:BYERLY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16072 110TH ST
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:IA
Mailing Address - Zip Code:50655-7514
Mailing Address - Country:US
Mailing Address - Phone:563-608-3828
Mailing Address - Fax:
Practice Address - Street 1:35 STATE AVE
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-6368
Practice Address - Country:US
Practice Address - Phone:507-332-4790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist