Provider Demographics
NPI:1861873531
Name:CONNER, BRITTANY NICOLE FOGG (PT, DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:NICOLE FOGG
Last Name:CONNER
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 COLSTON LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-9441
Mailing Address - Country:US
Mailing Address - Phone:502-330-9446
Mailing Address - Fax:
Practice Address - Street 1:482 COLSTON LN
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-9441
Practice Address - Country:US
Practice Address - Phone:502-330-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006606225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist