Carson Douglas Bryant

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Emory, VA

NPI 1194233791 · NPPES record last updated Jan 17, 2018

Key facts

NPI
1194233791
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
30461 Garnand Dr
Emory, VA 24327
Phone
(276) 944-6500
NPI assigned
Jan 17, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes
Athletic Trainer
Group: 193400000X SINGLE SPECIALTY GROUP
2255A2300X

Addresses

Primary practice location

30461 Garnand Dr
Emory, VA 24327

Mailing address

30461 Garnand Dr
Emory, VA 24327

Other providers in Emory, VA

All providers in Emory, VA · Student in an Organized Health Care Education/Training Program in Virginia

Sources for this page

Verify at the official NPI Registry.