Provider Demographics
NPI:1508313008
Name:COLSTON, BRITTANY LEANN
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEANN
Last Name:COLSTON
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 1:162 OLD TODDS RD
Mailing Address - Street 2:STE 260
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1340
Mailing Address - Country:US
Mailing Address - Phone:859-654-0119
Mailing Address - Fax:859-652-3903
Practice Address - Street 1:615 DELZAN PL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3503
Practice Address - Country:US
Practice Address - Phone:859-219-2233
Practice Address - Fax:859-219-3322
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9326225100000X
KY007224225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist