Provider Demographics
NPI:1760013130
Name:WOOLWINE, BRITTNI (RD, LMT)
Entity Type:Individual
Prefix:
First Name:BRITTNI
Middle Name:
Last Name:WOOLWINE
Suffix:
Gender:F
Credentials:RD, LMT
Other - Prefix:
Other - First Name:EDEN
Other - Middle Name:
Other - Last Name:WOOLWINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:770 W MAIN ST APT 4
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-4347
Mailing Address - Country:US
Mailing Address - Phone:540-392-9772
Mailing Address - Fax:
Practice Address - Street 1:102 LANDSDOWNE ST
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-5814
Practice Address - Country:US
Practice Address - Phone:540-392-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered