Individual
AMANDA E BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1520 S MAIN ST, SUITE 3, DAYTON, OH 45409-2698
(937) 208-7240
(937) 208-7242
Mailing address
1520 S MAIN ST, SUITE 3, DAYTON, OH 45409-2698
(937) 208-7240
(937) 208-7242
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50002691
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067774
—
OH
Enumeration date
10/31/2007
Last updated
11/19/2013
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