Individual
MS. GWEN LEIGH BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
134 EASTWOOD ACRES, NITRO, WV 25143-1400
(304) 389-5645
Mailing address
134 EASTWOOD ACRES, NITRO, WV 25143-1400
(304) 359-5645
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/26/2011
Last updated
12/26/2011
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