Provider Demographics
NPI:1205546173
Name:BLACKBURN, BRITTNEY DAWN (DPT)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:DAWN
Last Name:BLACKBURN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8509 NW 109TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-3020
Mailing Address - Country:US
Mailing Address - Phone:479-632-1111
Mailing Address - Fax:
Practice Address - Street 1:6020 NW 120TH CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1729
Practice Address - Country:US
Practice Address - Phone:405-751-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist