Healthcare Provider Details

I. General information

NPI: 1619859980
Provider Name (Legal Business Name): CATHY BROWN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1691 BIENVILLE DR
MONROE LA
71201-3756
US

IV. Provider business mailing address

2174 HIGHWAY 33
MARION LA
71260-3106
US

V. Phone/Fax

Practice location:
  • Phone: 318-343-6100
  • Fax:
Mailing address:
  • Phone: 479-276-6432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number3596
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: