Individual
BRYAN SCOTT EDMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
523 FENTON PL, CHARLOTTE, NC 28207-1919
(704) 302-1524
Mailing address
523 FENTON PL, CHARLOTTE, NC 28207-1919
(704) 302-1524
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3182
NC
Other
Enumeration date
10/03/2006
Last updated
07/19/2012
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