Provider Demographics
NPI:1144383522
Name:KING, BRITT ALLAN (OTR)
Entity type:Individual
Prefix:MR
First Name:BRITT
Middle Name:ALLAN
Last Name:KING
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 WILLOW BROOK DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355
Mailing Address - Country:US
Mailing Address - Phone:931-723-3734
Mailing Address - Fax:931-723-3734
Practice Address - Street 1:128 OLD SMITHVILLE HWY
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110
Practice Address - Country:US
Practice Address - Phone:931-473-8431
Practice Address - Fax:931-473-3941
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1373225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist