Provider Demographics
NPI:1295285088
Name:DAVIS, BRITTANY LYNNE (LAC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNNE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 N MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-3314
Mailing Address - Country:US
Mailing Address - Phone:512-648-0610
Mailing Address - Fax:
Practice Address - Street 1:320 N MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-3314
Practice Address - Country:US
Practice Address - Phone:512-648-0610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01613171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist