ETHAN RICHARD BRYAN

MEDFORD, NY
NPI1851083075
Former NameETHAN RICHARD BRYAN
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  331262)
Enumeration Date2023-05-25
Last Update Date2023-05-25
Business Address
Mr. ETHAN RICHARD BRYAN LPN
14 LOVERS LN
MEDFORD, NY 11763-4081
Phone number: 631-312-3744
Mailing Address
Mr. ETHAN RICHARD BRYAN LPN
14 LOVERS LN
MEDFORD, NY 11763-4081
Phone number: 631-312-3744
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