Bryan, Thomas J

Bryan, Thomas J is an individual health care provider with primary practice located at 4455 Highway 169 N , Plymouth MN 55442-2897. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bryan, Thomas J can be contacted via phone (763) 559-7358.

Contact Information

Primary practice address
4455 Highway 169 N Plymouth MN 55442-2897
Phone: (763) 559-7358
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3012 Minnesota

Profile Details

NPI number 1285695528
LBN Legal business name Bryan, Thomas J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Sep 26th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285695528 NPPES
Minnesota MEDICAID 915642900

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