Individual
MICHAEL RICHARD BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
1919 LATHROP ST, SUITE #123, FAIRBANKS, AK 99701-5937
(907) 455-4401
(907) 455-4402
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
432
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT0432
—
AK
Enumeration date
10/19/2006
Last updated
06/23/2016
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