Individual
DR. JOHN ROBERT BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6013 W OVERLAND RD STE 101, BOISE, ID 83709-3078
(208) 344-4469
(208) 344-0005
Mailing address
6013 W OVERLAND RD STE 101, BOISE, ID 83709-3078
(208) 344-4469
(208) 344-0005
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1963
ID
111NR0400X
Rehabilitation Chiropractor
CHIA-1963
ID
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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