Provider Demographics
NPI:1891210126
Name:BRYANT, EMILY (OD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 COBURN AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-3314
Mailing Address - Country:US
Mailing Address - Phone:307-431-6398
Mailing Address - Fax:307-347-3990
Practice Address - Street 1:618 COBURN AVE STE 12
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-3314
Practice Address - Country:US
Practice Address - Phone:307-431-6398
Practice Address - Fax:307-347-3990
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY414T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist