Organization
BRYANT LIFE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER ALEXANDER BRYANT JR. OTR/L (OCCUPATIONAL THERAPIST)
(917) 837-2452
Entity
Organization
Contact information
Practice address
8316 229TH ST, QUEENS VILLAGE, NY 11427-2155
(917) 837-2452
Mailing address
8316 229TH ST, QUEENS VILLAGE, NY 11427-2155
(917) 837-2452
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
251E00000X
Home Health Agency
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
10/15/2021
Last updated
12/03/2021
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