Provider Demographics
NPI:1285098996
Name:MCEACHERN, BRYCE
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:MCEACHERN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8633 SKYWARD CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4854
Mailing Address - Country:US
Mailing Address - Phone:702-256-1832
Mailing Address - Fax:
Practice Address - Street 1:8633 SKYWARD CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-4854
Practice Address - Country:US
Practice Address - Phone:702-256-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program