Individual
BRYAN GLEN PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
BLDG 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FT. RUCKER, AL 36362-5333
(334) 255-7000
Mailing address
BLDG 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FT. RUCKER, AL 36362-5333
(334) 255-7000
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
B1901448
TX
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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