Individual
ALTON JOLYON BRISPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 HOLLAND AVE, ALBANY, NY 12208-3410
(518) 626-5803
Mailing address
150 MANCHESTER RD, SCHENECTADY, NY 12304-3903
(518) 372-4903
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
004751-1/1021100057
NY
Other
Enumeration date
08/07/2006
Last updated
07/08/2007
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