Organization
BRYAN FALLIS
Active
Other names
Progressive Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN V. FALLIS DPM (OWNER)
(513) 931-0083
Entity
Organization
Contact information
Practice address
4415B AICHOLTZ RD STE 200, CINCINNATI, OH 45245-5135
(513) 931-0083
(859) 331-2449
Mailing address
PO BOX 636389, CINCINNATI, OH 45263-0001
(513) 931-0083
(859) 331-2449
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000619072
ANTHEM
—
05
—
2214213
—
OH
05
—
2955422
—
OH
Enumeration date
05/27/2009
Last updated
05/14/2024
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