Individual
MR. BRYCE WADE CONLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
705 W LOWRY RD, STE #101, CLAREMORE, OK 74017-2106
(918) 697-8945
(918) 341-3779
Mailing address
705 W LOWRY RD, STE #101, CLAREMORE, OK 74017-2106
(918) 697-8945
(918) 341-3779
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3731
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000063070A
—
OK
Enumeration date
06/17/2006
Last updated
05/04/2014
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