Basic Information
Provider Information
NPI: 1225390222
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THOMAS
FirstName: BRITTANY
MiddleName: LAUREN
NamePrefix: MRS.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10 WILLIAM POPE DR
Address2: SUITE 3
City: BLUFFTON
State: SC
PostalCode: 299097549
CountryCode: US
TelephoneNumber: 8437059440
FaxNumber: 8437059445
Practice Location
Address1: 10 WILLIAM POPE DR
Address2: SUITE 3
City: BLUFFTON
State: SC
PostalCode: 299097549
CountryCode: US
TelephoneNumber: 8437059440
FaxNumber: 8437059445
Other Information
ProviderEnumerationDate: 06/14/2012
LastUpdateDate: 04/28/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT27312FLN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X GAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT7722SCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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