Individual
BRYSON JAMES ROBUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 110, FORT WAYNE, IN 46845-1673
(260) 425-6780
(260) 425-6789
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28232997A
IN
363L00000X
Nurse Practitioner
Primary
71010835A
IN
Other
Enumeration date
11/04/2020
Last updated
10/14/2022
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