Provider Demographics
NPI:1508341173
Name:GREIG, BRITTANY MORGAN (MMT, CPT, MT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MORGAN
Last Name:GREIG
Suffix:
Gender:F
Credentials:MMT, CPT, MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 S MAIN ST LOWR
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-3639
Mailing Address - Country:US
Mailing Address - Phone:760-362-9188
Mailing Address - Fax:
Practice Address - Street 1:150 E WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-3061
Practice Address - Country:US
Practice Address - Phone:760-362-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13440225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist