Healthcare Provider Details

I. General information

NPI: 1669186417
Provider Name (Legal Business Name): BRANDON TRONE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 BARRETT STATION RD
SAINT LOUIS MO
63131-1606
US

IV. Provider business mailing address

606 E BOONESLICK RD
WARRENTON MO
63383-2102
US

V. Phone/Fax

Practice location:
  • Phone: 314-470-5636
  • Fax: 314-988-4757
Mailing address:
  • Phone: 636-400-3213
  • Fax: 636-238-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2023000538
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: