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General NPI Number Information
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NPI Number | 1225964356
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Entity Type | Individual
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Provider Name | PHILIP TODD BRYANT
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Gender | Male
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 106 E MARION ST
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City | PILOT MOUNTAIN
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State | NC
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Zip | 27041-8671
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Country | US
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Telephone | 336-448-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 OSCAR FRYE RD
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City | PINNACLE
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State | NC
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Zip | 27043-8269
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Country | US
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Telephone | 336-448-4145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | NC
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