Provider Demographics
NPI:1649568841
Name:BYUS FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:BYUS FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BYUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-644-2260
Mailing Address - Street 1:249 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:VT
Mailing Address - Zip Code:05444-9773
Mailing Address - Country:US
Mailing Address - Phone:802-644-2260
Mailing Address - Fax:802-644-5746
Practice Address - Street 1:249 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:VT
Practice Address - Zip Code:05444-9773
Practice Address - Country:US
Practice Address - Phone:802-644-2260
Practice Address - Fax:802-644-5746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0060079419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty