Individual
NICHOLAS BRYAN CORP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1901 HOAG ROAD, MOUNT VERNON, WA 98273
(360) 814-2184
(360) 814-5515
Mailing address
PO BOX 1376, MOUNT VERNON, WA 98273-1376
(360) 814-2184
(360) 814-5515
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160132794
WA
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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