Provider Demographics
NPI:1457965311
Name:WALTERS, BRITTNEY LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:LYNN
Last Name:WALTERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:LYNN
Other - Last Name:PRUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:191 W 200 S
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-1813
Mailing Address - Country:US
Mailing Address - Phone:140-271-9484
Mailing Address - Fax:
Practice Address - Street 1:1301 E M ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-3521
Practice Address - Country:US
Practice Address - Phone:307-532-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist