Provider Demographics
NPI:1205513587
Name:BRYANT, CELESTE (OD)
Entity type:Individual
Prefix:DR
First Name:CELESTE
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 1:301 ROYAL OAKS BLVD APT 2406
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-4414
Mailing Address - Country:US
Mailing Address - Phone:931-581-9665
Mailing Address - Fax:
Practice Address - Street 1:5238 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2459
Practice Address - Country:US
Practice Address - Phone:931-489-1950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3821152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist