MEDICARE: BRYAN EMERSON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2009000026	MO

General Provider Information

NPI Number	:	1528486743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYAN EMERSON DC

Provider Business Mailing Address
First Line	:	655 CRAIG RD STE 155
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-7173
Country	:	US
Telephone Number	:	314-755-1097
Fax Number	:	866-497-7496

Provider Business Practice Location Address
First Line	:	655 CRAIG RD STE 155
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-7173
Country	:	US
Telephone Number	:	314-755-1097
Fax Number	:	866-497-7496

Authorized Official
Title or Position	:	OWNER
Name	:	BRYAN EMERSON
Credential	:	DC
Telephone Number	:	636-395-3845

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	03/11/2024

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Directions to “BRYAN EMERSON DC ” Practice Location

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