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NPI Code Detail

MEDICARE: BRYCE STAFFORD HELTON

MEDICARE: BRYCE STAFFORD HELTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1174129183
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYCE STAFFORD HELTON
Provider Business Mailing Address
First Line : 9900 N DAVIS HWY
Second Line :
City : PENSACOLA
State : FL
Zip : 32514-8124
Country : US
Telephone Number : 850-607-6910
Fax Number :
Provider Business Practice Location Address
First Line : 9900 N DAVIS HWY
Second Line :
City : PENSACOLA
State : FL
Zip : 32514-8124
Country : US
Telephone Number : 850-607-6910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2020
Last Update Date : 12/07/2020

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Directions to “ BRYCE STAFFORD HELTON ” Practice Location

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