Individual
DALE OWEN BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2331 E 15TH ST, DOUGLAS, AZ 85607-2505
(520) 226-4184
Mailing address
2331 E 15TH ST, DOUGLAS, AZ 85607-2505
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5622
AZ
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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