Provider Demographics
NPI:1578740940
Name:BYRNE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:BYRNE CHIROPRACTIC, INC.
Other - Org Name:GIRARD CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-545-8170
Mailing Address - Street 1:1 PETRO PL STE 2
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-3123
Mailing Address - Country:US
Mailing Address - Phone:330-545-8170
Mailing Address - Fax:
Practice Address - Street 1:1 PETRO PL STE 2
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-3123
Practice Address - Country:US
Practice Address - Phone:330-545-8170
Practice Address - Fax:330-545-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0315673Medicaid
OH000000182895OtherANTHEM
OH04270058300OtherBWC
OH042700583001OtherMEDICAL MUTUAL
OH2058393Medicaid
OH2576OtherSTATE OF OHIO
OH2576OtherSTATE OF OHIO