Individual
MR. BRYANT RANDALL KEARNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
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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