MEDICARE: BRYANT CHIROPRACTIC CLINIC, LLC

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
1	111N00000X	Chiropractor	2308	AL
2	111N00000X	Chiropractor	1180	AL

General Provider Information

NPI Number	:	1306151493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYANT CHIROPRACTIC CLINIC, LLC

Provider Business Mailing Address
First Line	:	1600 SPARKMAN DR NW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35816-1114
Country	:	US
Telephone Number	:	256-837-8111
Fax Number	:	256-837-6200

Provider Business Practice Location Address
First Line	:	1600 SPARKMAN DR NW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35816-1114
Country	:	US
Telephone Number	:	256-837-8111
Fax Number	:	256-837-6200

Authorized Official
Title or Position	:	OWNER/TREATING PHYSICIAN
Name	:	DR. MARTIN G BRYANT
Credential	:	D.C.
Telephone Number	:	256-837-8111

Provider Enumeration Date	:	08/12/2010
Last Update Date	:	08/12/2010

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