Individual
TERRA F BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 444-3620
Mailing address
425 BROADWAY ST, PADUCAH, KY 42001-0713
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/24/2012
Last updated
06/16/2016
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