Provider Information for 1134146707
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SHEVENE BRYANT
Sex: Female
NPI: 1134146707
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1134146707 | ||||||||
| Enumeration Date | 2006-07-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 315 WENTWORTH CIR MEBANE, NC 27302-7191 United States Phone: 336-229-5905 | Fax: | ||||||||
| Primary Practice Address | 915 S MAIN ST BURLINGTON, NC 27215-5756 United States Phone: 336-229-5905 | Fax: | ||||||||
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