Provider Demographics
NPI:1992342554
Name:WEST, BRITTANY BURDSALL (OT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:BURDSALL
Last Name:WEST
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35437 OAK MANOR AVE
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3156
Mailing Address - Country:US
Mailing Address - Phone:225-773-4962
Mailing Address - Fax:
Practice Address - Street 1:1300 LAWRENCE PKWY
Practice Address - Street 2:
Practice Address - City:SAINT GABRIEL
Practice Address - State:LA
Practice Address - Zip Code:70776-5133
Practice Address - Country:US
Practice Address - Phone:225-773-4962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200174208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation