Provider Demographics
NPI:1720467442
Name:BRITTON, AMANDA RENEA
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:RENEA
Last Name:BRITTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-2381
Mailing Address - Country:US
Mailing Address - Phone:903-723-3602
Mailing Address - Fax:903-731-9573
Practice Address - Street 1:800 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-2381
Practice Address - Country:US
Practice Address - Phone:903-723-3602
Practice Address - Fax:903-731-9573
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
TX12368852251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist