Healthcare Provider Details

I. General information

NPI: 1013576800
Provider Name (Legal Business Name): ASHLEIGH BROWN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 06/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 US 64B
ALMA AR
72921-7292
US

IV. Provider business mailing address

4505 N RUDY RD
VAN BUREN AR
72956-9062
US

V. Phone/Fax

Practice location:
  • Phone: 479-651-3389
  • Fax: 479-474-4044
Mailing address:
  • Phone: 479-651-3389
  • Fax: 479-474-4044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: