Provider Demographics
NPI:1942367958
Name:HEWARD, BRYAN D (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:D
Last Name:HEWARD
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 1:1095 W QUEEN CREEK RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-8130
Mailing Address - Country:US
Mailing Address - Phone:480-814-7715
Mailing Address - Fax:480-814-7792
Practice Address - Street 1:1095 W QUEEN CREEK ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-8130
Practice Address - Country:US
Practice Address - Phone:480-814-7115
Practice Address - Fax:480-814-7792
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ65555Medicare ID - Type UnspecifiedPROVIDER #