Individual
MR. DANIEL BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
300 TENNEY ST, KEWANEE, IL 61443-3452
(309) 853-5500
(309) 853-4150
Mailing address
PO BOX 5387, BLOOMINGTON, IL 61702-5387
(309) 661-8823
(309) 661-8801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-007537
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-007537
IL LICENSE NO
IL
Enumeration date
05/05/2006
Last updated
04/20/2011
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