Individual
BRYANNA RENEE MOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT LAT ATC
Contact information
Practice address
650 E PARKWAY S, MEMPHIS, TN 38104-5568
(870) 941-9402
Mailing address
1800 SABLE PL APT 2, MEMPHIS, TN 38134-6559
(870) 941-9402
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2544
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
AR
Enumeration date
06/11/2021
Last updated
06/11/2021
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