Provider Demographics
NPI:1871044032
Name:METZ, BRYCE
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:METZ
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 1:1109 W OMAHA ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2448
Mailing Address - Country:US
Mailing Address - Phone:605-791-4327
Mailing Address - Fax:605-791-4328
Practice Address - Street 1:1109 W OMAHA ST
Practice Address - Street 2:SUITE C
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2448
Practice Address - Country:US
Practice Address - Phone:605-791-4327
Practice Address - Fax:605-791-4328
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD422H237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist