Individual
DR. GORDON B BYRNE
Active
Individual
DR. GORDON B BYRNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2576
OH
111NS0005X
Sports Physician Chiropractor
Primary
2576
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2068393
—
OH
01
—
2576
LICENSE
OH
01
—
34-1860598
TAX ID
OH
Enumeration date
05/27/2005
Last updated
04/25/2024
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