Individual
ELIZABETH BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 N KEENE ST STE 101, COLUMBIA, MO 65201-6986
(573) 874-0001
Mailing address
300 CENTRAL ST, ROCHEPORT, MO 65279-9812
(573) 698-2002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114829
LICENSE #
MO
Enumeration date
08/24/2006
Last updated
07/08/2007
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