Provider Demographics
NPI:1922469121
Name:BEYOND BONES CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:BEYOND BONES CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:208-209-5551
Mailing Address - Street 1:2362 N OLD MILL LOOP
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4954
Mailing Address - Country:US
Mailing Address - Phone:208-209-5551
Mailing Address - Fax:208-209-5558
Practice Address - Street 1:2362 N OLD MILL LOOP
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4954
Practice Address - Country:US
Practice Address - Phone:208-209-5551
Practice Address - Fax:208-209-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty