Individual
BRITTANIE CHEYENNE BOTTOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
535 N BRAND BLVD STE 502, GLENDALE, CA 91203-1962
(877) 206-8009
Mailing address
535 N BRAND BLVD STE 502, GLENDALE, CA 91203-1962
(877) 206-8009
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O07-619-839
DRIVERS LICENSE
KY
Enumeration date
07/01/2022
Last updated
07/01/2022
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