Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 10065 | AZ |
N | 2251S0007X | Physical Therapist - Sports | 10065 | AZ |
Y | 2251X0800X | Physical Therapist - Orthopedic | 10065 | AZ |
NPI | 1073858957 |
---|---|
Provider Name | Mrs. Brittany Elizabeth Cline |
First Address | Phoenix, AZ 85023-1261 |
Second Address | Tucson, AZ 85721-0095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2012 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
812811 | (05) | AZ |