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Individual

AMANDA M BRYANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
70 PST OFFICE PARK, WILBRAHAM, MA 01095
(413) 598-7770
Mailing address
70 POST OFFICE PARK, WILBRAHAM, MA 01095-1290

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2294531
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110126974A
MA
Enumeration date
06/06/2017
Last updated
12/28/2017
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