Individual
STACIA T BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
14 BRIDGEWATERS DR STE A, OCEANPORT, NJ 07757-1184
(732) 542-6600
Mailing address
13 ORLA CT, TINTON FALLS, NJ 07724-4402
(908) 309-8241
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
40QA00211000
NJ
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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