Provider Demographics
NPI:1700126125
Name:BRYANT, HOLLY F (CMT)
Entity Type:Individual
Prefix:MISS
First Name:HOLLY
Middle Name:F
Last Name:BRYANT
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 INDIANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:VA
Mailing Address - Zip Code:22572-3530
Mailing Address - Country:US
Mailing Address - Phone:804-761-2851
Mailing Address - Fax:
Practice Address - Street 1:439 INDIANFIELD RD
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:VA
Practice Address - Zip Code:22572-3530
Practice Address - Country:US
Practice Address - Phone:804-761-2851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019010768174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist