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Individual

MS. MAMIE BRYANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2951 S KING DR, APT. 1317, CHICAGO, IL 60616-3344
(312) 326-3694
(312) 326-3694
Mailing address
2951 SO. KING DR., APT. 1317, CHICAGO, IL 60616-3362
(312) 326-3694
(312) 326-3694

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041-168769
IL

Other

Enumeration date
07/19/2011
Last updated
07/19/2011
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