| Doctor Name: | STACIA T BRYANT |
| NPI Number: | 1104171156 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHYSICAL THERAPIST |
| License Number: | 40QA00211000 |
| Business Practice Address: | 14 Bridgewaters Dr Ste A Oceanport, NJ - 077571184 |
| Business Phone Number: | 7325426600 |
| Business Fax Number: | |
| Mailing Address: | 13 Orla Ct, TINTON FALLS |
| State: | NJ |
| Postal Code: | 077244402 |
| Phone Number: | 9083098241 |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2012 |
| NPI Last Update Date: | 07/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 40QA00211000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |