Healthcare Provider Details

I. General information

NPI: 1235650938
Provider Name (Legal Business Name): SCHLONDA SUE BROWN MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 07/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 US HIGHWAY 23 S STE 5
PIKEVILLE KY
41501-3701
US

IV. Provider business mailing address

70 OLD PENNY RD
VIRGIE KY
41572-8392
US

V. Phone/Fax

Practice location:
  • Phone: 606-639-1200
  • Fax: 606-639-1020
Mailing address:
  • Phone: 606-794-2417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number003984
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: