Doctor Name: | ALEX BRYANT |
NPI Number: | 1780073684 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 011163 |
Business Practice Address: | 150 Red Oak Ct Pine Mountain, GA - 318223645 |
Business Phone Number: | 7063256971 |
Business Fax Number: | |
Mailing Address: | 150 Red Oak Ct, PINE MOUNTAIN |
State: | GA |
Postal Code: | 318223645 |
Phone Number: | 7063256971 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2015 |
NPI Last Update Date: | 01/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 011163 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |