Provider Demographics
NPI:1376642199
Name:DR. ERIC G. BRYANT, D.C., P.C.
Entity Type:Organization
Organization Name:DR. ERIC G. BRYANT, D.C., P.C.
Other - Org Name:VOHRINGER & BRYANT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-420-8620
Mailing Address - Street 1:4219 INDIAN RIVER RD
Mailing Address - Street 2:SUITE A
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
Practice Address - Street 2:SUITE A
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA318304OtherBLUE CROSS/BLUE SHIELD
VA318304OtherBLUE CROSS/BLUE SHIELD