Individual
MR. CORNELL BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2604 PALO DURO DR, 155, SAN ANGELO, TX 76904-7597
(512) 909-4454
Mailing address
2604 PALO DURO DR, 155, SAN ANGELO, TX 76904-7597
(512) 909-4454
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2107773
TX
Other
Enumeration date
11/03/2015
Last updated
11/10/2015
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