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NPI Code Detail

MEDICARE: MR. BRYAN A ARJON

MEDICARE: MR. BRYAN A ARJON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1710403084
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYAN A ARJON
Provider Business Mailing Address
First Line : 4338 HAYES TOWER RD
Second Line :
City : GAYLORD
State : MI
Zip : 49735-8885
Country : US
Telephone Number : 719-551-8053
Fax Number :
Provider Business Practice Location Address
First Line : (MTC) MICHIGAN THERAPEUTIC CONSULTANTS
Second Line : 711 S ILLINOIS AVE
City : GAYLORD
State : MI
Zip : 49735-1763
Country : US
Telephone Number : 989-732-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2017
Last Update Date : 08/18/2017

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