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General NPI Number Information
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NPI Number | 1376642199
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Entity Type | Organization
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Legal Business Name | DR. ERIC G. BRYANT, D.C., P.C.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 4219 INDIAN RIVER RD SUITE A
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City | CHESAPEAKE
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State | VA
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Zip | 23325-3041
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Country | US
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Telephone | 757-420-8620
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Fax | 757-424-1670
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Provider Business Mailing Address
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Address Line | 4219 INDIAN RIVER RD SUITE A
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City | CHESAPEAKE
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State | VA
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Zip | 23325-3041
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Country | US
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Telephone | 757-420-8620
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Fax | 757-424-1670
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Authorized Official
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Title or Position | PRESIDENT/OPERATOR
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Name | DR. ERIC BRYANT
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Credential | D.C.
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Telephone | 757-420-8620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104555759
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License Number State | VA
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