Individual
DR. THOMAS J BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4455 HIGHWAY 169 N, PLYMOUTH, MN 55442-2897
(763) 559-7358
Mailing address
1140 POND CURV, WACONIA, MN 55387-3103
(763) 498-2751
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3012
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
915642900
—
MN
Enumeration date
03/28/2006
Last updated
09/26/2013
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