Provider Demographics
NPI:1255689113
Name:BRYANT, CHRISTEEN (LMT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTEEN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44400 W HONEYCUTT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-2945
Mailing Address - Country:US
Mailing Address - Phone:520-494-7670
Mailing Address - Fax:
Practice Address - Street 1:44400 W HONEYCUTT RD STE 101
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-2945
Practice Address - Country:US
Practice Address - Phone:520-494-7376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-12514225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist