Individual
MR. GRANT MATTHEW O'BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3718 BROADWAY ST, QUINCY, IL 62305-2822
(217) 728-1505
Mailing address
1415 W HIGHWAY 50, O FALLON, IL 62269-1618
(618) 624-4471
(618) 624-4496
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3405
IL
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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