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Organization

EDWIN D BRYAN INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWIN D BRYAN OD (OPTOMETRIST)
(251) 929-3191
Entity
Organization

Contact information

Practice address
701 MCMEANS AVE, BAY MINETTE, AL 36507-3337
(251) 937-1397
Mailing address
12930 MARY ANN BEACH RD, FAIRHOPE, AL 36532-5423
(251) 929-3191

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
S-490-TA-140
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5152800
BCBS
AL
Enumeration date
03/11/2008
Last updated
04/03/2008
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