Provider Demographics
NPI:1548426950
Name:BRYJA, EDWARD JAMES (KT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JAMES
Last Name:BRYJA
Suffix:
Gender:M
Credentials:KT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 30TH STREET
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310
Mailing Address - Country:US
Mailing Address - Phone:515-699-5999
Mailing Address - Fax:515-699-5743
Practice Address - Street 1:3600 30TH STREET
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310
Practice Address - Country:US
Practice Address - Phone:515-699-5999
Practice Address - Fax:515-699-5743
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist