Provider Demographics
NPI:1033830716
Name:PRYOR, ALLEN C JR
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:C
Last Name:PRYOR
Suffix:JR
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 1:8373 CHRISTOPHER LN
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-4655
Mailing Address - Country:US
Mailing Address - Phone:352-777-9523
Mailing Address - Fax:
Practice Address - Street 1:8373 CHRISTOPHER LN
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34613-4655
Practice Address - Country:US
Practice Address - Phone:352-777-9523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician