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1205954104
MARK E BRYANT
PORTSMOUTH, VA
NPI
1205954104
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2007-03-27
Last Update Date
2007-07-08
Business Address
-- MARK E BRYANT IDC
620 JOHN PAUL JONES CIR
PORTSMOUTH, VA 23708-2111
Phone number: 757-953-9000
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Mailing Address
-- MARK E BRYANT IDC
4621 MARLWOOD WAY
VIRGINIA BEACH, VA 23462-7244
Phone number: 757-953-8883
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