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General NPI Number Information
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NPI Number | 1730643354
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Entity Type | Individual
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Provider Name | MS. BRITTANY A TALLHAMER
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Gender | Female
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 8220 NATURES WAY
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-4204
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Country | US
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Telephone | 304-615-9268
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Fax |
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Provider Business Mailing Address
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Address Line | 1804 78TH ST NW
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City | BRADENTON
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State | FL
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Zip | 34209-9725
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Country | US
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Telephone | 304-615-9268
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT18427
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT32328
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License Number State | FL
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