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General NPI Number Information
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NPI Number | 1528486743
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Entity Type | Organization
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Legal Business Name | BRYAN EMERSON DC
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Dates
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Enumeration Date | 04/03/2014
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 655 CRAIG RD STE 155
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City | CREVE COEUR
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State | MO
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Zip | 63141-7173
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Country | US
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Telephone | 314-755-1097
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Fax | 866-497-7496
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Provider Business Mailing Address
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Address Line | 655 CRAIG RD STE 155
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City | CREVE COEUR
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State | MO
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Zip | 63141-7173
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Country | US
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Telephone | 314-755-1097
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Fax | 866-497-7496
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Authorized Official
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Title or Position | OWNER
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Name | BRYAN EMERSON
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Credential | DC
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Telephone | 636-395-3845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2009000026
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License Number State | MO
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