Provider Demographics
NPI:1376214791
Name:BRIERLEY, JONATHON SCOTT (MSAT, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:JONATHON
Middle Name:SCOTT
Last Name:BRIERLEY
Suffix:
Gender:M
Credentials:MSAT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10413 E CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-7915
Mailing Address - Country:US
Mailing Address - Phone:469-974-5131
Mailing Address - Fax:
Practice Address - Street 1:10413 E CLOVER LN
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-7915
Practice Address - Country:US
Practice Address - Phone:469-974-5131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
TX390200000X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program