Provider Demographics
NPI:1588389753
Name:JAY BRYNER PA-C PLLC
Entity type:Organization
Organization Name:JAY BRYNER PA-C PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PA-C
Authorized Official - Phone:828-222-4625
Mailing Address - Street 1:2270 HENDERSONVILLE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-2734
Mailing Address - Country:US
Mailing Address - Phone:828-222-4625
Mailing Address - Fax:
Practice Address - Street 1:2270 HENDERSONVILLE RD STE 1
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-2734
Practice Address - Country:US
Practice Address - Phone:828-222-4625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health