Bryant Healthy Living, LLC
Nurse Practitioner, Family in Lynwood, IL. Organization (NPI-2).
NPI number1164044236
StatusActive
Last updated in NPPESJun 16, 2020
Details
- NPI
- 1164044236
- Entity type
- Organization (NPI-2)
- Legal business name
- Bryant Healthy Living, LLC
- Organization subpart
- No
- Enumeration date
- May 12, 2020
- Certification date
- Jun 16, 2020
- Last updated
- Jun 16, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Other names
- Braynt Healthy Living (Doing Business As)
Practice location
19404 N. Creek DriveLynwood, IL 60411
Phone 708-252-0521
Mailing address
19404 N. Creek DriveLynwood, IL 60411
Phone 708-252-0521
Authorized official
William Bryant
Ceo
7082520521
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