Provider Demographics
NPI:1871720193
Name:DELONEY, BRYAN ALLEN (DC)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:ALLEN
Last Name:DELONEY
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 1:126 HILLTOWN VILLAGE CTR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-0709
Mailing Address - Country:US
Mailing Address - Phone:314-226-4492
Mailing Address - Fax:
Practice Address - Street 1:12977 N 40 DR STE 105
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8654
Practice Address - Country:US
Practice Address - Phone:636-590-4686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010009588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor