Provider Demographics
NPI:1487976262
Name:BRYCE CHIROPRACTIC CENTER LLC
Entity type:Organization
Organization Name:BRYCE CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:BOYCE
Authorized Official - Last Name:BRYCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-771-2345
Mailing Address - Street 1:119 GARDEN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-2913
Mailing Address - Country:US
Mailing Address - Phone:928-771-2345
Mailing Address - Fax:928-771-0951
Practice Address - Street 1:119 GARDEN ST
Practice Address - Street 2:SUITE C
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-2913
Practice Address - Country:US
Practice Address - Phone:928-771-2345
Practice Address - Fax:928-771-0951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6031111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty