Individual
SUSAN EVON BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
539 BARHAMS RIDGE DR, MCDONOUGH, GA 30252-5800
(770) 876-9737
Mailing address
539 BARHAMS RIDGE DR, MCDONOUGH, GA 30252-5800
(770) 876-9737
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
201134574
KY
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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