Provider Demographics
NPI:1033673942
Name:YOUNG, BRYSON PAIGE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:BRYSON
Middle Name:PAIGE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 S FM 369
Mailing Address - Street 2:
Mailing Address - City:BURKBURNETT
Mailing Address - State:TX
Mailing Address - Zip Code:76354-2846
Mailing Address - Country:US
Mailing Address - Phone:940-631-2737
Mailing Address - Fax:
Practice Address - Street 1:1701 S FM 369
Practice Address - Street 2:
Practice Address - City:BURKBURNETT
Practice Address - State:TX
Practice Address - Zip Code:76354-2846
Practice Address - Country:US
Practice Address - Phone:940-631-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer