Individual
ERICA BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4121 W GORE BLVD, LAWTON, OK 73505-6336
(580) 357-3857
Mailing address
4121 W GORE BLVD, LAWTON, OK 73505-6336
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/04/2013
Last updated
04/03/2014
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