Provider Demographics
NPI:1538649504
Name:CHARLE, BRITTNI (PT,DPT)
Entity Type:Individual
Prefix:
First Name:BRITTNI
Middle Name:
Last Name:CHARLE
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3848 W CARSON ST STE 110
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6704
Mailing Address - Country:US
Mailing Address - Phone:424-488-3191
Mailing Address - Fax:
Practice Address - Street 1:3848 W CARSON ST STE 110
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6704
Practice Address - Country:US
Practice Address - Phone:424-488-3191
Practice Address - Fax:310-933-4803
Is Sole Proprietor?:No
Enumeration Date:2018-08-18
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA295397OtherPHYSICAL THERAPY BOARD OF CALIFORNIA