Healthcare Provider Details
I. General information
NPI: 1548281603
Provider Name (Legal Business Name): BRYON SNELSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/22/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
816 TUSCULUM BLVD
GREENEVILLE TN
37745-4092
US
IV. Provider business mailing address
816 TUSCULUM BLVD
GREENEVILLE TN
37745-4092
US
V. Phone/Fax
- Phone: 423-639-1431
- Fax: 423-639-0827
- Phone: 423-639-1431
- Fax: 423-639-0827
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 1036 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: