Provider Demographics
NPI:1538306584
Name:EMERSON, BRYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:EMERSON
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 1:655 CRAIG RD STE 155
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7173
Mailing Address - Country:US
Mailing Address - Phone:314-755-1097
Mailing Address - Fax:866-497-7496
Practice Address - Street 1:655 CRAIG RD STE 155
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7173
Practice Address - Country:US
Practice Address - Phone:314-755-1097
Practice Address - Fax:866-497-7496
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009000026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor