Healthcare Provider Details

I. General information

NPI: 1780749846
Provider Name (Legal Business Name): BRITTANY CIARAMITA P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY BERRY P.T.

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 LACLEDE AVE
SAINT LOUIS MO
63103-2011
US

IV. Provider business mailing address

5544 DUGAN AVE
SAINT LOUIS MO
63110-2932
US

V. Phone/Fax

Practice location:
  • Phone: 314-977-7419
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2004005482
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: