Individual
BRYAN ALLEN MIZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
324 CRESTVIEW CIRCLE, MEDIA, PA 19063
(484) 680-3790
Mailing address
324 CRESTVIEW CIR, MEDIA, PA 19063-1737
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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