Provider Demographics
NPI:1518004506
Name:BRYMAN, JON H (DC)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:H
Last Name:BRYMAN
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 1:1303 VETERANS HWY
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-2514
Mailing Address - Country:US
Mailing Address - Phone:215-755-3800
Mailing Address - Fax:215-826-8223
Practice Address - Street 1:1303 VETERANS HWY
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-2514
Practice Address - Country:US
Practice Address - Phone:215-788-3800
Practice Address - Fax:215-826-8223
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007544L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA609920OtherHIGHMARK
PA609920OtherHIGHMARK