Provider Demographics
NPI:1609318013
Name:KENT, BRYAN MORAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:MORAN
Last Name:KENT
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 1:285 HARVARD ST APT 301
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-2374
Mailing Address - Country:US
Mailing Address - Phone:585-410-2081
Mailing Address - Fax:
Practice Address - Street 1:285 HARVARD ST APT 301
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-2374
Practice Address - Country:US
Practice Address - Phone:585-410-2081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor