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General NPI Number Information
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NPI Number | 1558635565
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Entity Type | Individual
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Provider Name | BRITTANY DAEL ROMICK MED, ATC, RN
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Gender | Female
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 156 OAKRIDGE DR
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City | CHOCTAW
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State | OK
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Zip | 73020-7682
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Country | US
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Telephone | 512-983-2232
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Fax |
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Provider Business Mailing Address
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Address Line | 156 OAKRIDGE DR
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City | CHOCTAW
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State | OK
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Zip | 73020-7682
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT4593
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R 0112639
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License Number State | OK
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