Healthcare Provider Details

I. General information

NPI: 1932522380
Provider Name (Legal Business Name): COURTNEY BROWN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2014
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 COOPER ST
AGAWAM MA
01001-2149
US

IV. Provider business mailing address

53 GREENWICH RD
EAST LONGMEADOW MA
01028-1416
US

V. Phone/Fax

Practice location:
  • Phone: 413-786-8000
  • Fax:
Mailing address:
  • Phone: 413-244-9359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number20611
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: