Provider Demographics
NPI:1538901657
Name:BRYANT, KRISTIAN
Entity type:Individual
Prefix:
First Name:KRISTIAN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25B ELM ST APT 28
Mailing Address - Street 2:
Mailing Address - City:FOXBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2560
Mailing Address - Country:US
Mailing Address - Phone:617-756-9318
Mailing Address - Fax:
Practice Address - Street 1:25B ELM ST APT 28
Practice Address - Street 2:
Practice Address - City:FOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:02035-2560
Practice Address - Country:US
Practice Address - Phone:617-756-9318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker