Provider Demographics
NPI:1922745405
Name:BRYANT, JOHN ROBERT (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBERT
Last Name:BRYANT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:865-694-0062
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:576 FORT LOUDOUN MEDICAL CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5676
Practice Address - Country:US
Practice Address - Phone:865-690-4861
Practice Address - Fax:865-988-8837
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14238225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist