Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 8644 | TN |
NPI | 1003137308 |
---|---|
Provider Name | Bryan Curtis Clary |
First Address | Chattanooga, TN 37404-3322 |
Second Address | Chattanooga, TN 37404-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2010 |
Last Update Date | 23/05/2012 |