Provider Demographics
NPI:1285317776
Name:QUINN, BRITTANY (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 S COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65809-3201
Mailing Address - Country:US
Mailing Address - Phone:417-849-6558
Mailing Address - Fax:
Practice Address - Street 1:405 RACETRACK RD NE STE 101
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-3960
Practice Address - Country:US
Practice Address - Phone:850-863-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20230302405225100000X
FLPT42253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist