Provider Demographics
NPI:1194563841
Name:BRYANT, JULIA CLANCY (OD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:CLANCY
Last Name:BRYANT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2699 TOWNSEND CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6487
Mailing Address - Country:US
Mailing Address - Phone:931-647-8417
Mailing Address - Fax:931-648-4435
Practice Address - Street 1:2699 TOWNSEND CT
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6487
Practice Address - Country:US
Practice Address - Phone:931-647-8417
Practice Address - Fax:931-648-4435
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3894152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist