Most Relevant Information
Provider Data
| NPI Number: | 1003535063 |
| Provider Name: | BRYAN OSAYAMHEN OKOSUN |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/24/2022 |
| Last Updated: | 08/24/2022 |
Provider Practice Location
720 WESTVIEW DR SW
ATLANTA
GA
303101458
Practice Location Phone/Fax
| Phone: | 4047521500 |
| Fax: |
Provider Mailing Location
720 WESTVIEW DR SW
ATLANTA
GA
303101458
Provider Mailing Phone/Fax
| Phone: | 4047521500 |
| Fax: |