Provider Demographics
NPI:1518248079
Name:MCCORMICK, BRITTNEY RAE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:RAE
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 UTICA RIDGE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1657
Mailing Address - Country:US
Mailing Address - Phone:563-326-1400
Mailing Address - Fax:563-326-0700
Practice Address - Street 1:3740 UTICA RIDGE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1657
Practice Address - Country:US
Practice Address - Phone:563-326-1400
Practice Address - Fax:563-326-0700
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002136225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist