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General NPI Number Information
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NPI Number | 1235411521
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Entity Type | Individual
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Provider Name | ANGELA P BRYANT CFTS
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Gender | Female
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 209 W 3RD ST
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City | PEMBROKE
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State | NC
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Zip | 28372-8768
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Country | US
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Telephone | 910-522-0009
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Fax | 910-521-5654
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Provider Business Mailing Address
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Address Line | 124 NESTLE LN
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City | LUMBERTON
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State | NC
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Zip | 28360-0563
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Country | US
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Telephone | 910-887-5106
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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 | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number | CFTS1147
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License Number State | NC
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