Healthcare Provider Details

I. General information

NPI: 1275878712
Provider Name (Legal Business Name): BRITTANY MICHELE LUNNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N 8TH ST SUITE 1R
PHILADELPHIA PA
19106-1531
US

IV. Provider business mailing address

14500 BUSTLETON AVE SUITE 1-A
PHILADELPHIA PA
19116-1188
US

V. Phone/Fax

Practice location:
  • Phone: 215-613-6523
  • Fax: 215-922-2228
Mailing address:
  • Phone: 215-613-6523
  • Fax: 215-613-6527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022466
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: