Individual
MR. BRYAN JAMES ANTONIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.T.
Contact information
Practice address
10004 204TH AVE E, SUITE 2600, BONNEY LAKE, WA 98391-6539
(253) 446-3983
(253) 862-5004
Mailing address
10004 204TH AVE E, SUITE 2600, BONNEY LAKE, WA 98391-6539
(253) 446-3983
(253) 862-5004
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
CRT-17967
AZ
2471C3402X
Radiography Radiologic Technologist
Primary
RT 60584477
WA
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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