Provider Demographics
NPI:1821285891
Name:CLAY, BRYAN KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:KEITH
Last Name:CLAY
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 1:1430 W CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4228
Mailing Address - Country:US
Mailing Address - Phone:903-463-5433
Mailing Address - Fax:903-463-5434
Practice Address - Street 1:1430 W CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4228
Practice Address - Country:US
Practice Address - Phone:903-463-5433
Practice Address - Fax:903-463-5434
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor