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Individual

MRS. JANE KITTRELL BRYANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
187 GALLAHER RD, KINGSTON, TN 37763-4721
(865) 376-4620
(865) 376-1759
Mailing address
211 CENTER PARK DR, SUITE 3060, KNOXVILLE, TN 37922-2108
(865) 966-8545
(865) 966-3936

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
077
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0045343
BLUECROSS BLUESHIELD
TN
05
5440740
TN
Enumeration date
07/07/2006
Last updated
07/08/2007
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