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Individual

JACOB RAYMOND BRYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MOTR L

Contact information

Practice address
815 S 200 W, BRIGHAM CITY, UT 84302
(435) 723-5289
(435) 723-0579
Mailing address
828 E 350 S, BRIGHAM CITY, UT 84302
(435) 730-5860
(435) 723-8781

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
11/27/2006
Last updated
07/08/2007
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