Provider Demographics
NPI:1760972269
Name:UTZ, BRITTANY NICHOLE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICHOLE
Last Name:UTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4668 PEMBROKE BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6423
Mailing Address - Country:US
Mailing Address - Phone:757-648-8562
Mailing Address - Fax:757-648-8564
Practice Address - Street 1:16260 BENNETT RD
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4630
Practice Address - Country:US
Practice Address - Phone:540-727-0737
Practice Address - Fax:540-727-0738
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist