Provider Demographics
NPI:1417403114
Name:ISEMINGER, BRITTANY
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:ISEMINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 485
Mailing Address - Street 2:7 EAST CEMETERY STREET
Mailing Address - City:FUNKSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21734
Mailing Address - Country:US
Mailing Address - Phone:240-291-8648
Mailing Address - Fax:
Practice Address - Street 1:499 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-7534
Practice Address - Country:US
Practice Address - Phone:240-291-8648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA005482255A2300X
WVAT0013772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer