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Individual

MR. BRYANT RANDALL KEARNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
250 26TH ST, PRAIRIE DU SAC, WI 53578-2204
(608) 643-2471
(608) 643-4788
Mailing address
250 26TH ST, PRAIRIE DU SAC, WI 53578-2204
(608) 643-2471
(608) 643-4788

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
2836-023
WI
363AS0400X
Surgical Physician Assistant
Primary
2836-023
WI

Other

Enumeration date
09/23/2011
Last updated
04/15/2021
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