Healthcare Provider Details

I. General information

NPI: 1851499636
Provider Name (Legal Business Name): DEBORAH BROWN BROWN RKT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 HOSPITAL RD 117
TUSKEGEE AL
36083-5001
US

IV. Provider business mailing address

333 ELLIS RD
SHORTER AL
36075-4006
US

V. Phone/Fax

Practice location:
  • Phone: 334-727-0550
  • Fax:
Mailing address:
  • Phone: 334-727-3490
  • Fax: 334-727-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: