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NPI Code Detail

MEDICARE: STACY MARIE BRITTON OTR/L

MEDICARE: STACY MARIE BRITTON OTR/L
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
1225X00000XOccupational Therapist1712OK

General Provider Information

NPI Number : 1932795705
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY MARIE BRITTON OTR/L
Provider Business Mailing Address
First Line : 6312 N PORTLAND AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-1463
Country : US
Telephone Number : 405-946-6932
Fax Number : 405-946-1882
Provider Business Practice Location Address
First Line : 6312 N PORTLAND AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-1463
Country : US
Telephone Number : 405-946-6932
Fax Number : 405-946-1882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2020
Last Update Date : 12/16/2020

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