Individual
MR. BRYAN MICHAEL BUMGARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4250 CHICKEN COOP RD, SUGAR GROVE, OH 43155-9725
(740) 746-8415
Mailing address
4250 CHICKEN COOP RD, SUGAR GROVE, OH 43155-9725
(740) 746-8415
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.118223M-IV
OH
Other
Enumeration date
07/30/2010
Last updated
07/30/2010
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