Healthcare Provider Details

I. General information

NPI: 1659485381
Provider Name (Legal Business Name): ERICA CHRISTINE BROWN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 WASHINGTON LN
AUGUSTA KS
67010-1638
US

IV. Provider business mailing address

873 LEXINGTON RD
WICHITA KS
67218-2729
US

V. Phone/Fax

Practice location:
  • Phone: 316-775-0700
  • Fax: 316-775-0730
Mailing address:
  • Phone: 316-775-0700
  • Fax: 316-775-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3555
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: