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General NPI Number Information
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NPI Number | 1235106121
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Entity Type | Individual
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Provider Name | ROY LEE BRYANT III P.T., M.T.
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Gender | Male
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 302 PADDLE WHEEL RD
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City | GILBERTSVILLE
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State | KY
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Zip | 42044-8853
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Country | US
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Telephone | 270-362-7269
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Fax |
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Provider Business Mailing Address
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Address Line | 302 PADDLE WHEEL RD
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City | GILBERTSVILLE
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State | KY
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Zip | 42044-8853
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Country | US
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Telephone | 270-362-7269
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 02752
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License Number State | KY
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