Provider Demographics
NPI:1154759579
Name:HOWLAND, BRYAN THOMAS (DC)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:THOMAS
Last Name:HOWLAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BRYAN
Other - Middle Name:THOMAS
Other - Last Name:HOWLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:21503 405TH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62363-2940
Mailing Address - Country:US
Mailing Address - Phone:217-473-6832
Mailing Address - Fax:
Practice Address - Street 1:21503 405TH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:IL
Practice Address - Zip Code:62363-2940
Practice Address - Country:US
Practice Address - Phone:217-473-6832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012519111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition