Provider Demographics
NPI:1073791968
Name:BRYANT, JESSICA DELL (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:DELL
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 WINKLER AVE
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6108
Mailing Address - Country:US
Mailing Address - Phone:254-699-4004
Mailing Address - Fax:254-699-4056
Practice Address - Street 1:1201 WINKLER AVE
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-6108
Practice Address - Country:US
Practice Address - Phone:254-699-4004
Practice Address - Fax:254-699-4056
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor