Provider Demographics
NPI:1548281603
Name:SNELSON, BRYON (DC)
Entity type:Individual
Prefix:DR
First Name:BRYON
Middle Name:
Last Name:SNELSON
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 1:816 TUSCULUM BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4092
Mailing Address - Country:US
Mailing Address - Phone:423-639-1431
Mailing Address - Fax:423-639-0827
Practice Address - Street 1:816 TUSCULUM BLVD
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4092
Practice Address - Country:US
Practice Address - Phone:423-639-1431
Practice Address - Fax:423-639-0827
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN179301OtherBLUE CROSS BLUE SHIELD
TN4440005OtherUNITED HEALTHCARE
TN3090494OtherCIGNA
TN55672OtherJOHN DEERE HEALTH CARE
TN299819OtherPHCS
TN55672OtherJOHN DEERE HEALTH CARE
TNU47111Medicare UPIN