Individual
BENJAMIN BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
605 NE SAVANNAH DR STE 3, BEND, OR 97701-4885
(858) 224-3604
Mailing address
339 SE REED MARKET RD APT L4, BEND, OR 97702-2275
(206) 715-5628
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26106
OR
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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