Provider Demographics
NPI:1356588172
Name:CLODFELTER, BRITTANY PHILLIPS (DPT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:PHILLIPS
Last Name:CLODFELTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ANN
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1508 W INNES ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2504
Mailing Address - Country:US
Mailing Address - Phone:704-630-9656
Mailing Address - Fax:
Practice Address - Street 1:1508 W INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2504
Practice Address - Country:US
Practice Address - Phone:704-630-9656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist