Provider Demographics
NPI:1679831986
Name:DALEY, BRITTANY ALISON (DPT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ALISON
Last Name:DALEY
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 1:100 EXECUTIVE WAY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2715
Mailing Address - Country:US
Mailing Address - Phone:904-543-9011
Mailing Address - Fax:904-543-1390
Practice Address - Street 1:100 EXECUTIVE WAY
Practice Address - Street 2:SUITE 109
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-2715
Practice Address - Country:US
Practice Address - Phone:904-543-9011
Practice Address - Fax:904-543-1390
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist