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Individual
BRYAN LANG
Active
Individual
BRYAN LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60214
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497172373
GROUP NPI
OR
Enumeration date
08/01/2013
Last updated
06/04/2014
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