Healthcare Provider Details

I. General information

NPI: 1336453513
Provider Name (Legal Business Name): BRYAN HUTCHINSON-REUSS LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HIGHWAY 6 W (11E)
IOWA CITY IA
52246-2292
US

IV. Provider business mailing address

601 HIGHWAY 6 W (11E)
IOWA CITY IA
52246-2292
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-0581
  • Fax: 319-688-3579
Mailing address:
  • Phone: 319-338-0581
  • Fax: 319-688-3579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number007056
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: