Provider Demographics
NPI:1598153439
Name:THOMSEN, BRITTANY (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:THOMSEN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 GOSPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13780-3103
Mailing Address - Country:US
Mailing Address - Phone:607-373-2019
Mailing Address - Fax:
Practice Address - Street 1:6142 STATE HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815
Practice Address - Country:US
Practice Address - Phone:607-373-2019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028515225700000X
NY028515-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist