Provider Demographics
NPI:1699503532
Name:ST. JOHN, DAVID BRIAN (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRIAN
Last Name:ST. JOHN
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 1:650 S ROCK BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4116
Mailing Address - Country:US
Mailing Address - Phone:775-391-3151
Mailing Address - Fax:
Practice Address - Street 1:650 S ROCK BLVD STE 6
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4116
Practice Address - Country:US
Practice Address - Phone:775-391-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB02055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor