Provider Demographics
NPI:1700516200
Name:BOSS, BRITTANY ANN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:ANN
Last Name:BOSS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BRYAN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55117-1080
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4935 PT FSDICK DR NW STE 200&300
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1851
Practice Address - Country:US
Practice Address - Phone:253-258-3355
Practice Address - Fax:253-258-3356
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12599225100000X
WA225100000X
COPTL.0018846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist