Provider Demographics
NPI:1780822668
Name:BRITT, CYNTHIA RENE (PT, GCS)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:RENE
Last Name:BRITT
Suffix:
Gender:F
Credentials:PT, GCS
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:R
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1908 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6031
Mailing Address - Country:US
Mailing Address - Phone:256-340-9708
Mailing Address - Fax:256-340-9624
Practice Address - Street 1:122 WALNUT STREET
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:AL
Practice Address - Zip Code:35042-4054
Practice Address - Country:US
Practice Address - Phone:205-926-5343
Practice Address - Fax:205-926-5345
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529917620Medicaid
AL1003819608OtherGROUP NPI
AL529917620Medicaid