Provider Demographics
NPI:1346429669
Name:BRYANT, ERIC GREGORY (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:GREGORY
Last Name:BRYANT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 INDIAN RIVER RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-3041
Mailing Address - Country:US
Mailing Address - Phone:757-420-8620
Mailing Address - Fax:757-424-1670
Practice Address - Street 1:4219 INDIAN RIVER RD STE A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-3041
Practice Address - Country:US
Practice Address - Phone:757-420-8620
Practice Address - Fax:757-424-1670
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor