MEDICARE: DR. BRYAN EMERSON D.C.

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	:	1538306584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN EMERSON D.C.

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2009
Last Update Date	:	03/11/2024

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