Provider Demographics
NPI:1568111631
Name:BEYER, BRYCE LANDES
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:LANDES
Last Name:BEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 ALCOA HWY STE B127
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1522
Mailing Address - Country:US
Mailing Address - Phone:865-305-8787
Mailing Address - Fax:865-305-8261
Practice Address - Street 1:1928 ALCOA HWY STE B127
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1522
Practice Address - Country:US
Practice Address - Phone:865-305-8787
Practice Address - Fax:865-305-8261
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program