Provider Demographics
NPI:1790859890
Name:BYERLY CHIROPRACTIC CLINIC PLC
Entity Type:Organization
Organization Name:BYERLY CHIROPRACTIC CLINIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:BYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-342-3018
Mailing Address - Street 1:322 S DELAWARE ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-1548
Mailing Address - Country:US
Mailing Address - Phone:641-342-3018
Mailing Address - Fax:
Practice Address - Street 1:322 S DELAWARE ST
Practice Address - Street 2:STE 100
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1548
Practice Address - Country:US
Practice Address - Phone:641-342-3018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1231688Medicaid
IA1231688Medicaid