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Individual

KELLY MARIE BRYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1421 PREMIER DR, MANKATO, MN 56001-6076
(507) 389-8529
Mailing address
1421 PREMIER DR, MANKATO, MN 56001-6076
(507) 389-8529

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
67340
MN
208000000X
Pediatrics Physician
R4609
KY

Other

Enumeration date
03/30/2017
Last updated
08/26/2020
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