Healthcare Provider Details

I. General information

NPI: 1487220315
Provider Name (Legal Business Name): BRITTANY WIDDOWSON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13835 N TATUM BLVD STE 9-429
PHOENIX AZ
85032-5581
US

IV. Provider business mailing address

13835 N TATUM BLVD STE 9-429
PHOENIX AZ
85032-5581
US

V. Phone/Fax

Practice location:
  • Phone: 602-708-9412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number31786
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number31786
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: