Provider Demographics
NPI:1558816298
Name:STAMBAUGH, BRITTANY (PT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:STAMBAUGH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 COLLEGE AVE.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3384
Mailing Address - Country:US
Mailing Address - Phone:717-358-0800
Mailing Address - Fax:717-358-0803
Practice Address - Street 1:233 COLLEGE AVE.
Practice Address - Street 2:SUITE 201
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3384
Practice Address - Country:US
Practice Address - Phone:717-358-0800
Practice Address - Fax:717-358-0803
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025341225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT025341OtherLICENSE