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Organization

BRYAN FALLIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRYAN V FALLIS DPM (PRESIDENT OWNER)
(513) 931-0083
Entity
Organization

Contact information

Practice address
644 EDEN PARK DR, CINCINNATI, OH 45202-6031
(513) 931-0083
(859) 331-2449
Mailing address
2300 CHAMBER CENTER DR STE 100, LAKESIDE PARK, KY 41017-1686
(859) 331-2440
(859) 689-0017

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6262030006
MEDICARE NSC
Enumeration date
09/22/2022
Last updated
09/22/2022
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