Individual
DR. JASON GREGORY BRANHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, MA
Contact information
Practice address
2901 RIVERS BND S, BONNE TERRE, MO 63628-3836
(901) 351-9703
Mailing address
2901 RIVERS BND S, BONNE TERRE, MO 63628-3836
(901) 351-9703
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
XXXXXXXXXXX
MO
111NS0005X
Sports Physician Chiropractor
0000000000000
MO
171400000X
Health & Wellness Coach
Primary
—
MO
Other
Enumeration date
03/22/2023
Last updated
04/23/2023
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