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Individual

BRYAN STEWART RISS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1907 NEW ROAD, NORTHFIELD, NJ 08255
(732) 797-1771
(732) 797-1818
Mailing address
438 COMMINS WAY, TOMS RIVER, NJ 08755
(732) 797-1771
(732) 797-1818

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00689300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38MC00689300
STATE LICENSE
NJ
Enumeration date
02/28/2011
Last updated
02/28/2011
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