Provider Demographics
NPI:1871253609
Name:BRYANT, LAUREN WILLIAMS (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:WILLIAMS
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 DEER PARK LN
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-2909
Mailing Address - Country:US
Mailing Address - Phone:706-879-9866
Mailing Address - Fax:
Practice Address - Street 1:1326 US HWY 41 S
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701
Practice Address - Country:US
Practice Address - Phone:706-879-9866
Practice Address - Fax:706-719-0139
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor