Individual
DR. IDELLA MARIE BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
167 N MAIN STREET, TUBA CITY, AZ 86045-0600
(928) 283-2754
(928) 283-2758
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2754
(928) 283-2758
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14773
AZ
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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