Provider Demographics
NPI:1710937560
Name:BARRON, BRYAN LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:LYNN
Last Name:BARRON
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 1:326 E BLACKSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-3741
Mailing Address - Country:US
Mailing Address - Phone:864-574-8024
Mailing Address - Fax:864-574-8124
Practice Address - Street 1:326 E BLACKSTOCK RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-3741
Practice Address - Country:US
Practice Address - Phone:864-574-8024
Practice Address - Fax:864-574-8124
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2557111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGCH515Medicaid
SC2557OtherSTATE LISCENSE
SCGCH515Medicaid