Provider Demographics
NPI:1063474294
Name:MCALLISTER, BRYON JAMES (ATC)
Entity Type:Individual
Prefix:MR
First Name:BRYON
Middle Name:JAMES
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8754 SIENNA DR
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-7898
Mailing Address - Country:US
Mailing Address - Phone:315-699-1742
Mailing Address - Fax:
Practice Address - Street 1:12 LIBERTY ST
Practice Address - Street 2:CAZENOVIA COLLEGE ATHLETIC CENTER
Practice Address - City:CAZENOVIA
Practice Address - State:NY
Practice Address - Zip Code:13035-1008
Practice Address - Country:US
Practice Address - Phone:315-655-7321
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000242-0227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified