Provider Demographics
NPI:1376060483
Name:GRIBBIN, BRITTANY LYNN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:LYNN
Last Name:GRIBBIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 PARK ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1546
Mailing Address - Country:US
Mailing Address - Phone:1949-485-1047
Mailing Address - Fax:
Practice Address - Street 1:2306 DEAN ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3209
Practice Address - Country:US
Practice Address - Phone:707-443-8354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT293530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist