Healthcare Provider Details

I. General information

NPI: 1407038227
Provider Name (Legal Business Name): JONI MCGINNIS BROWN I P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 GERRISH RD
ROCHESTER MA
02770-1815
US

IV. Provider business mailing address

23 GERRISH RD
ROCHESTER MA
02770-1815
US

V. Phone/Fax

Practice location:
  • Phone: 508-763-4162
  • Fax:
Mailing address:
  • Phone: 508-763-4162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5221
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: