Individual
HARRIETTE PEACOCK BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPED, CFM
Contact information
Practice address
7130 BLUE RIDGE DR, BLUE RIDGE, GA 30513-3605
(706) 632-0384
(706) 946-0385
Mailing address
7130 BLUE RIDGE DR, BLUE RIDGE, GA 30513-3605
(706) 632-0384
(706) 946-0385
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
—
—
224L00000X
Pedorthist
Primary
PED0000000064
TN
Other
Enumeration date
07/24/2012
Last updated
07/01/2013
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