Provider Demographics
NPI:1316547813
Name:BRYANT CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:BRYANT CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:BS,DC
Authorized Official - Phone:563-324-1514
Mailing Address - Street 1:5216 SHERIDAN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-3978
Mailing Address - Country:US
Mailing Address - Phone:563-324-1514
Mailing Address - Fax:
Practice Address - Street 1:5216 SHERIDAN ST STE 130
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-3978
Practice Address - Country:US
Practice Address - Phone:563-324-1514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty