Healthcare Provider Details

I. General information

NPI: 1659500361
Provider Name (Legal Business Name): MORGAN BROWN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8725 S KYRENE RD
TEMPE AZ
85284-2116
US

IV. Provider business mailing address

8725 S KYRENE RD
TEMPE AZ
85284-2116
US

V. Phone/Fax

Practice location:
  • Phone: 480-756-8617
  • Fax: 480-820-9909
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8515
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: