Individual
BETTY REGINA BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5543 WESCONNETT BLVD, JACKSONVILLE, FL 32244-1947
(904) 647-5019
Mailing address
5543 WESCONNETT BLVD, JACKSONVILLE, FL 32244-1947
(904) 641-5019
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
12/30/2015
Last updated
12/30/2015
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