Provider Demographics
NPI:1326819160
Name:BRYSON, THOMAS F JR (RD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:F
Last Name:BRYSON
Suffix:JR
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SPRINGFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1662
Mailing Address - Country:US
Mailing Address - Phone:267-475-1976
Mailing Address - Fax:
Practice Address - Street 1:133 SPRINGFIELD DR
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1662
Practice Address - Country:US
Practice Address - Phone:267-475-1976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA86331619133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered