Provider Demographics
NPI:1396196028
Name:THOMAS, BRITTNEY (LMT)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 239
Mailing Address - Street 2:
Mailing Address - City:SKAGWAY
Mailing Address - State:AK
Mailing Address - Zip Code:99840-0239
Mailing Address - Country:US
Mailing Address - Phone:907-612-0428
Mailing Address - Fax:
Practice Address - Street 1:302 5TH AVE.
Practice Address - Street 2:
Practice Address - City:SKAGWAY
Practice Address - State:AK
Practice Address - Zip Code:99840
Practice Address - Country:US
Practice Address - Phone:907-612-0428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK104006225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist