Individual
JUANITA E BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
125 E CHERRY ST, BLUFFTON, IN 46714
(260) 824-3500
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3513
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000231A
IN
Other
Enumeration date
02/08/2006
Last updated
12/11/2018
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