=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780148775
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY LEIGH PRIMLEY OTR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2019
-----------------------------------------------------
Last Update Date | 03/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1400 BELLINGER ST
-----------------------------------------------------
City | EAU CLAIRE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54703-5222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-838-5222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2404 RIVERS EDGE DR
-----------------------------------------------------
City | ALTOONA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54720-1494
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-725-8965
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 6430-26
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------