Provider Demographics
NPI:1720869324
Name:TRANT, BRYCE PATRICK
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:PATRICK
Last Name:TRANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 WILLIAMSON RD SE APT 104
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1809
Mailing Address - Country:US
Mailing Address - Phone:540-842-2139
Mailing Address - Fax:
Practice Address - Street 1:206 WILLIAMSON RD SE APT 104
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24011-1809
Practice Address - Country:US
Practice Address - Phone:540-842-2139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant