Provider Demographics
NPI:1083190383
Name:BRYANT CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:BRYANT CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:DRAKE
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-499-8331
Mailing Address - Street 1:5800 HIDCOTE DR.
Mailing Address - Street 2:SUITE #102
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516
Mailing Address - Country:US
Mailing Address - Phone:402-499-8331
Mailing Address - Fax:
Practice Address - Street 1:5800 HIDCOTE DR.
Practice Address - Street 2:SUITE #102
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5503
Practice Address - Country:US
Practice Address - Phone:402-499-8331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty