Organization
JANE K BRYANT
Active
Other names
KIDS KABIN
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANE KITTRELL BRYANT OCCUPATIONAL THERAPY (OTR/SOLE PROPRIETOR)
(865) 376-4620
Entity
Organization
Contact information
Practice address
187 GALLAHER RD, KINGSTON, TN 37763-4721
(865) 376-4620
(865) 376-1759
Mailing address
187 GALLAHER RD, KINGSTON, TN 37763-4721
(865) 376-4620
(865) 376-1759
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
77
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004074553
BCBS GROUP PROVIDER NUMBE
TN
Enumeration date
07/11/2007
Last updated
06/30/2008
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