Provider Demographics
NPI:1477761435
Name:BRITT, DEANNA DALE (PT)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:DALE
Last Name:BRITT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:DALE
Other - Last Name:BRITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1002 SW 104TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2990
Mailing Address - Country:US
Mailing Address - Phone:405-691-5801
Mailing Address - Fax:
Practice Address - Street 1:1002 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2990
Practice Address - Country:US
Practice Address - Phone:405-212-5308
Practice Address - Fax:405-212-5312
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT1297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKPT1297OtherPT LICENSURE NUMBER