NPI Code Detail JSON Logo

1760629331 NPI number — OMER BRYANT PHYSICAL THERAPIST

NPI Number: 1760629331
Health Care Provider/Practitioner: OMER BRYANT PHYSICAL THERAPIST

Information about “1760629331” NPI (OMER BRYANT PHYSICAL THERAPIST) exists in 1760629331 in HTML format HTML  |  1760629331 in plain Text format TXT  |  1760629331 in PDF (Portable Document Format) PDF  |  1760629331 in an XML format XML  formats.

NPI Number : 1760629331 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1760629331",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BRYANT",
    "FirstName": "OMER",
    "MiddleName": null,
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "PHYSICAL THERAPIST",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11658 N 142ND DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SURPRISE",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85379-4950",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "303-947-0824",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1601 SW ARCHER RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GAINESVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32608-1135",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "352-376-1611",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/19/2009",
    "LastUpdateDate": "01/23/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "6792",
        "LicenseNumberStateCode": "CO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.