Provider Demographics
NPI:1184910226
Name:CLEMENTS, BRITTANY LAUREN (PT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LAUREN
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2990 TELESTAR CT
Mailing Address - Street 2:SUITE 3PT
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1207
Mailing Address - Country:US
Mailing Address - Phone:571-423-5742
Mailing Address - Fax:571-423-5700
Practice Address - Street 1:3620 JOSEPH SIEWICK DR
Practice Address - Street 2:SUITE 106
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1756
Practice Address - Country:US
Practice Address - Phone:703-391-2450
Practice Address - Fax:703-391-3142
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305206944225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist