Individual
MR. BRYAN ANTHONY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
606 HIGHWAY 63 S, VIENNA, MO 65582-8101
(573) 422-3636
(573) 422-3434
Mailing address
606 HIGHWAY 63 S, VIENNA, MO 65582-8101
(573) 422-3636
(573) 202-2433
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1300
OK
Other
Enumeration date
11/14/2005
Last updated
03/24/2021
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