Provider Demographics
NPI:1558083030
Name:MANCIL, BRITTANY (PTA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MANCIL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 SW 121ST TER
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432-3613
Mailing Address - Country:US
Mailing Address - Phone:352-615-9313
Mailing Address - Fax:
Practice Address - Street 1:8320 SW 121ST TER
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432-3613
Practice Address - Country:US
Practice Address - Phone:352-615-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA242172081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine