Provider Demographics
NPI:1073965471
Name:HALEY, BRITTANY BROOKE (ATC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:BROOKE
Last Name:HALEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209B KAY LN
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-3525
Mailing Address - Country:US
Mailing Address - Phone:785-227-5696
Mailing Address - Fax:
Practice Address - Street 1:200 S 14TH ST
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4201
Practice Address - Country:US
Practice Address - Phone:785-227-5696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-009572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer