Provider Demographics
NPI:1467798041
Name:SCOTT, BRITNEY LAINE (PTA)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:LAINE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:BRITNEY
Other - Middle Name:LAINE
Other - Last Name:WILLOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-0302
Mailing Address - Country:US
Mailing Address - Phone:580-651-5433
Mailing Address - Fax:580-246-5433
Practice Address - Street 1:121 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-4206
Practice Address - Country:US
Practice Address - Phone:580-651-5433
Practice Address - Fax:580-246-5433
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-02348225200000X
OK1278225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant