Provider Demographics
NPI:1528430766
Name:KIRKLEY, BRITTANY (OTR/L)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:KIRKLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2698 E 1150 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62465-4014
Mailing Address - Country:US
Mailing Address - Phone:217-493-2686
Mailing Address - Fax:
Practice Address - Street 1:1111 W NORTH 12TH ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62565-9554
Practice Address - Country:US
Practice Address - Phone:217-774-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056009495225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist