Provider Demographics
NPI:1952656944
Name:DEUSO, BRITTANY RENEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:RENEE
Last Name:DEUSO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:RENEE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:135 HANBURY RD W STE B
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-4291
Practice Address - Country:US
Practice Address - Phone:757-819-6512
Practice Address - Fax:757-819-6517
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP01362155OtherMEDICARE RR PTAN
VA1952656944OtherMEDICAID QMB
VAC05954OtherMEDICARE GROUP PTAN
VAQ45503AMedicare PIN