Healthcare Provider Details

I. General information

NPI: 1215765581
Provider Name (Legal Business Name): BRITTANY NICOLE PERRY PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31507 OAK ORCHARD RD STE 8
MILLSBORO DE
19966-5012
US

IV. Provider business mailing address

31507 OAK ORCHARD RD STE 8
MILLSBORO DE
19966-5012
US

V. Phone/Fax

Practice location:
  • Phone: 302-648-3360
  • Fax: 302-648-3362
Mailing address:
  • Phone: 302-648-3360
  • Fax: 302-648-3362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberJ2-0011573
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: