| Doctor Name: | DR. BRYAN LEE JARVIS |
| NPI Number: | 1881989119 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OT014339 |
| Business Practice Address: | 5515 Peach St Erie, PA - 165092603 |
| Business Phone Number: | 5866126638 |
| Business Fax Number: | |
| Mailing Address: | 571 Saint Josephs Blvd, Fl 2 ELMIRA |
| State: | NY |
| Postal Code: | 149013230 |
| Phone Number: | 6072712050 |
| Fax Number: | 6078731244 |
| NPI Enumeration Date: | 06/15/2011 |
| NPI Last Update Date: | 05/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OT014339 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |