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General NPI Number Information
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NPI Number | 1780260828
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Entity Type | Individual
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Provider Name | BRYANT ANTON ROBINSON EP
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Gender | Male
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 16127 WICK RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-1462
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Country | US
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Telephone | 313-800-3303
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Fax |
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Provider Business Mailing Address
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Address Line | 41232 CANTON CT
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City | CANTON
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State | MI
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Zip | 48188-1469
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Country | US
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Telephone | 734-383-3631
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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 | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State | MI
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