Provider Demographics
NPI:1821655549
Name:STURGILL, BRITTANY (PTA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:STURGILL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:434 WHITAKER ST
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37879-3330
Mailing Address - Country:US
Mailing Address - Phone:423-489-5522
Mailing Address - Fax:
Practice Address - Street 1:136 DAVIS LN
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3118
Practice Address - Country:US
Practice Address - Phone:423-562-0760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7055225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7055OtherTENNESSEE BOARD OF PHYSICAL THERAPY