Healthcare Provider Details

I. General information

NPI: 1881006229
Provider Name (Legal Business Name): BRITTANY SEXSON PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W 2ND ST
GOODLAND KS
67735-1602
US

IV. Provider business mailing address

PO BOX 272
SHARON SPRINGS KS
67758-0272
US

V. Phone/Fax

Practice location:
  • Phone: 785-890-6021
  • Fax: 785-890-6035
Mailing address:
  • Phone: 785-821-4744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number14-02102
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: