Individual
MRS. MARY IRENE BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
660 GOLDEN RIDGE RD, SUITE 250, GOLDEN, CO 80401-9541
(303) 233-1223
(303) 233-8755
Mailing address
660 GOLDEN RIDGE RD, SUITE 250, GOLDEN, CO 80401-9541
(303) 233-1223
(303) 233-8755
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 2308
CO
363AM0700X
Medical Physician Assistant
Primary
2308
CO
363AM0700X
Medical Physician Assistant
AMD-329
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2308
LICENSE
CO
01
—
A00133
STATE NARC
HI
01
—
AMD-329
HI LIC.
HI
Enumeration date
10/18/2006
Last updated
03/07/2023
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