Provider Demographics
NPI:1053183483
Name:BELLINO, BRITTANY NICOLE
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICOLE
Last Name:BELLINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:NICOLE
Other - Last Name:VILLAGRANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAIDEN NAME
Mailing Address - Street 1:1055 COUNTY ROAD 13A
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:CO
Mailing Address - Zip Code:81226-9563
Mailing Address - Country:US
Mailing Address - Phone:719-232-1701
Mailing Address - Fax:
Practice Address - Street 1:722 S 8TH ST
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-4906
Practice Address - Country:US
Practice Address - Phone:719-345-4097
Practice Address - Fax:719-249-1516
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015106225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant