Provider Demographics
NPI:1598311342
Name:MILLER, BRITTANY MARY
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARY
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4693 GOLDEN KEY RD
Mailing Address - Street 2:
Mailing Address - City:KEMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:19529-9134
Mailing Address - Country:US
Mailing Address - Phone:484-258-8720
Mailing Address - Fax:
Practice Address - Street 1:4693 GOLDEN KEY RD
Practice Address - Street 2:
Practice Address - City:KEMPTON
Practice Address - State:PA
Practice Address - Zip Code:19529-9134
Practice Address - Country:US
Practice Address - Phone:484-258-8720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE012229225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant