Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath |
NPI | 1871985218 |
---|---|
Provider Name | Mr. William Bryant III |
First Address | Newark, NJ 07112-1417 |
Second Address | Newark, NJ 07112-1417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2015 |
Last Update Date | 23/02/2015 |