Provider Demographics
NPI:1902111347
Name:BRYANT, LOUISE EDITH (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:EDITH
Last Name:BRYANT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BRIGHAMS COVE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-6762
Mailing Address - Country:US
Mailing Address - Phone:207-774-9873
Mailing Address - Fax:
Practice Address - Street 1:1 FRONT ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2492
Practice Address - Country:US
Practice Address - Phone:207-774-9873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1974111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition