Healthcare Provider Details

I. General information

NPI: 1881987469
Provider Name (Legal Business Name): DENISE K ALBRITTON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28487 STATE HWY W
WARRENTON MO
63383-4629
US

IV. Provider business mailing address

29604 W STATE HIGHWAY 94
MARTHASVILLE MO
63357-3518
US

V. Phone/Fax

Practice location:
  • Phone: 636-359-0225
  • Fax:
Mailing address:
  • Phone: 636-932-4623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2008012538
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: