Provider Demographics
NPI:1558814228
Name:FORSTER, BRITTANY (DPT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:FORSTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 HAND AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-1135
Mailing Address - Country:US
Mailing Address - Phone:386-673-3535
Mailing Address - Fax:386-673-3530
Practice Address - Street 1:1425 HAND AVE
Practice Address - Street 2:SUITE H
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-1135
Practice Address - Country:US
Practice Address - Phone:386-673-3535
Practice Address - Fax:386-673-3530
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist