Individual
MR. BRYAN STANDLEY POE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
406 S PARK AVE, AZTEC, NM 87410
(505) 334-2852
(505) 334-9266
Mailing address
6405 S 3000 E STE 300, SALT LAKE CITY, UT 84121-6977
(801) 266-3113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A83486
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40931
—
NM
Enumeration date
11/16/2006
Last updated
02/05/2024
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