| Doctor Name: | JENNIFER BRYCE |
| NPI Number: | 1265551097 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 5601002383 |
| Business Practice Address: | 1 William Carls Dr Commerce Township, MI - 483822201 |
| Business Phone Number: | 2489374764 |
| Business Fax Number: | 2489374729 |
| Mailing Address: | 42557 Woodward Ave, Ste 130 BLOOMFIELD HILLS |
| State: | MI |
| Postal Code: | 483045206 |
| Phone Number: | 2483223088 |
| Fax Number: | 2483224175 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 06/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601002383 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |