MEDICARE: BRITTNEY REDWINE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1219252	TX

General Provider Information

NPI Number	:	1750636619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY REDWINE DPT

Provider Business Mailing Address
First Line	:	5217 82ND ST
Second Line	:	SUITE 104
City	:	LUBBOCK
State	:	TX
Zip	:	79424-2827
Country	:	US
Telephone Number	:	806-687-4311
Fax Number	:	806-687-4313

Provider Business Practice Location Address
First Line	:	5217 82ND ST
Second Line	:	SUITE 104
City	:	LUBBOCK
State	:	TX
Zip	:	79424-2827
Country	:	US
Telephone Number	:	806-687-4311
Fax Number	:	806-687-4313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	04/08/2015

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Directions to “ BRITTNEY REDWINE DPT” Practice Location

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