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NPI Code Detail

MEDICARE: KEVIN BRYANT

MEDICARE: KEVIN BRYANT
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1922436468
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN BRYANT
Provider Business Mailing Address
First Line : 2633 BLUE REEF DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-3695
Country : US
Telephone Number : 702-372-1997
Fax Number :
Provider Business Practice Location Address
First Line : 2633 BLUE REEF DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-3695
Country : US
Telephone Number : 702-372-1997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2013
Last Update Date : 10/18/2013

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Directions to “ KEVIN BRYANT ” Practice Location

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