Provider Demographics
NPI:1639310378
Name:BRYANT, JOSEPH DANIEL (COTA)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DANIEL
Last Name:BRYANT
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 T B STANLEY HWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-6108
Mailing Address - Country:US
Mailing Address - Phone:276-627-8660
Mailing Address - Fax:276-627-8661
Practice Address - Street 1:324 T B STANLEY HWY
Practice Address - Street 2:SUITE F
Practice Address - City:BASSETT
Practice Address - State:VA
Practice Address - Zip Code:24055-6108
Practice Address - Country:US
Practice Address - Phone:276-627-8660
Practice Address - Fax:276-627-8661
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant