Provider Demographics
NPI:1730235573
Name:ZALES, BRYAN W (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:W
Last Name:ZALES
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 1:7100 S CLINTON ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3616
Mailing Address - Country:US
Mailing Address - Phone:303-790-6000
Mailing Address - Fax:
Practice Address - Street 1:7100 S CLINTON ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3616
Practice Address - Country:US
Practice Address - Phone:303-790-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT956111N00000X
CO6446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor