Provider Demographics
NPI:1427582113
Name:DAVIS, BRITTANY LOREN (ATC LAT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LOREN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ATC LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CAMINO SANTA MARIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-5433
Mailing Address - Country:US
Mailing Address - Phone:210-431-5043
Mailing Address - Fax:
Practice Address - Street 1:1 CAMINO SANTA MARIA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-5433
Practice Address - Country:US
Practice Address - Phone:210-431-5043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT57662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer