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Individual

MR. BRYCE WILLARD GAUNT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T., SCS

Contact information

Practice address
2300 MANCHESTER EXPY, SUITE 101B, COLUMBUS, GA 31904-6802
(706) 256-0825
(706) 256-0830
Mailing address
965 LEE ROAD 288, SMITHS, AL 36877-2670
(334) 297-9690

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3680
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3680
GEORGIA STATE LICENSE
GA
Enumeration date
06/13/2006
Last updated
07/08/2007
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