Provider Demographics
NPI:1437392537
Name:MUTH, BRYAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:E
Last Name:MUTH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 RAINPOINTE WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-4472
Mailing Address - Country:US
Mailing Address - Phone:865-242-7244
Mailing Address - Fax:865-769-8028
Practice Address - Street 1:6519 NIGHTINGALE LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2753
Practice Address - Country:US
Practice Address - Phone:865-242-7244
Practice Address - Fax:865-769-2028
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor