Individual
RUSSELL WAYNE BRYAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
450 TURNER ST, BRANCH HEALTH CLINIC, NAVAL AIR STATION, PENSACOLA, FL 32508-5211
(850) 452-5242
Mailing address
5800 W FAIRFIELD DR, PENSACOLA, FL 32506-3440
(850) 455-4201
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110840787
VA
Other
Enumeration date
01/18/2006
Last updated
07/08/2007
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