| Doctor Name: | DR. BRYCE ANDREW PASCHOLD |
| NPI Number: | 1003103045 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | 135000742 |
| Business Practice Address: | 2160 S 1st Ave Maywood, IL - 601533328 |
| Business Phone Number: | 7082164254 |
| Business Fax Number: | |
| Mailing Address: | 20054 N 1000 East Rd, CARLOCK |
| State: | IL |
| Postal Code: | 617259568 |
| Phone Number: | 3092423333 |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2011 |
| NPI Last Update Date: | 06/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 135000742 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |