Provider Demographics
NPI:1578909412
Name:BRYNAN, CHARLES WILLIAM III (MPR)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:WILLIAM
Last Name:BRYNAN
Suffix:III
Gender:M
Credentials:MPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 HENNING RD
Mailing Address - Street 2:
Mailing Address - City:PERKIOMENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18074-9501
Mailing Address - Country:US
Mailing Address - Phone:215-234-4834
Mailing Address - Fax:
Practice Address - Street 1:965 HENNING RD
Practice Address - Street 2:
Practice Address - City:PERKIOMENVILLE
Practice Address - State:PA
Practice Address - Zip Code:18074-9501
Practice Address - Country:US
Practice Address - Phone:215-234-4834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist