Provider Demographics
NPI:1215358809
Name:CLANCY, BRITTANY (DPT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:CLANCY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:LILLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:NY
Mailing Address - Zip Code:14506-0725
Mailing Address - Country:US
Mailing Address - Phone:585-582-6273
Mailing Address - Fax:
Practice Address - Street 1:207 1/2 LAKE ST
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1802
Practice Address - Country:US
Practice Address - Phone:315-536-4051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 40913225100000X
NY045955225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist