Individual
BRYN VAN HOOMISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2825 STOCKYARD RD STE I-200, MISSOULA, MT 59808-1548
(406) 728-8420
(406) 541-8430
Mailing address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MED-PHYS-LIC-66778
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
NC
Other
Enumeration date
04/04/2014
Last updated
06/20/2018
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