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Individual

JAVONUNA BRYANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7632 THRUSH AVE, FORT WAYNE, IN 46816-2662
(260) 241-8743
Mailing address
7632 THRUSH AVE, FORT WAYNE, IN 46816-2662
(260) 241-8743

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
HOME CARE
IN
Enumeration date
08/13/2024
Last updated
08/13/2024
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