Healthcare Provider Details

I. General information

NPI: 1225206923
Provider Name (Legal Business Name): JOHN B BRITTAIN LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 PLEASANT LAKE AVE
HARWICH MA
02645-2661
US

IV. Provider business mailing address

64 THORWALD DR
SOUTH DENNIS MA
02660-3208
US

V. Phone/Fax

Practice location:
  • Phone: 508-432-7399
  • Fax:
Mailing address:
  • Phone: 508-394-8425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number225
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: