Provider Demographics
NPI:1578869723
Name:THAYER, BRITTANY MICHELLE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:THAYER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9413 APISON PIKE STE 108
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-5628
Mailing Address - Country:US
Mailing Address - Phone:423-584-1739
Mailing Address - Fax:888-865-7424
Practice Address - Street 1:9413 APISON PIKE STE 108
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-5628
Practice Address - Country:US
Practice Address - Phone:423-584-1739
Practice Address - Fax:888-865-7424
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMT0000008114174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist