Provider Demographics
NPI:1497259485
Name:KIRK, BRITTANY (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:KIRK
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 S 82ND ST APT 35
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-5539
Mailing Address - Country:US
Mailing Address - Phone:609-313-0220
Mailing Address - Fax:
Practice Address - Street 1:101 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-1400
Practice Address - Country:US
Practice Address - Phone:717-867-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0076352255A2300X
NJ25MT002906002255A2300X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer