Provider Demographics
NPI:1114334281
Name:O'BRYANT, DANIEL GERALD (ATC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:GERALD
Last Name:O'BRYANT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
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Mailing Address - Street 1:5385 DEATSVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:DEATSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36022-6066
Mailing Address - Country:US
Mailing Address - Phone:334-830-8753
Mailing Address - Fax:
Practice Address - Street 1:1160 NAVARRO AVENUE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106
Practice Address - Country:US
Practice Address - Phone:334-830-8753
Practice Address - Fax:334-833-4026
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer