Provider Demographics
NPI:1568893949
Name:GUESS, BRYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:GUESS
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 1:2441 STATE ST STE 10
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4962
Mailing Address - Country:US
Mailing Address - Phone:812-945-4500
Mailing Address - Fax:812-945-4808
Practice Address - Street 1:2441 STATE ST STE 10
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4962
Practice Address - Country:US
Practice Address - Phone:812-945-4500
Practice Address - Fax:812-945-4808
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002814A111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN12631704OtherCAQH
KY7100407750Medicaid