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NPI Code Detail

MEDICARE: DR. BRITTANY NICOLE PALISH DPT

MEDICARE: DR. BRITTANY NICOLE PALISH DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPTL.0014107CO
2225100000XPhysical TherapistPT302203CA

General Provider Information

NPI Number : 1881047173
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRITTANY NICOLE PALISH DPT
Provider Business Mailing Address
First Line : 408 HIGUERA ST STE 200
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-6135
Country : US
Telephone Number : 805-788-0805
Fax Number : 805-788-0845
Provider Business Practice Location Address
First Line : 4869 S BRADLEY RD STE 114
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-5088
Country : US
Telephone Number : 805-938-5320
Fax Number : 805-938-5390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2016
Last Update Date : 10/24/2023

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