Healthcare Provider Details

I. General information

NPI: 1699082917
Provider Name (Legal Business Name): ALEXANDRA MACY BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10084 REISTERSTOWN RD
OWINGS MILLS MD
21117-4096
US

IV. Provider business mailing address

10084 REISTERSTOWN RD
OWINGS MILLS MD
21117-4096
US

V. Phone/Fax

Practice location:
  • Phone: 443-394-2680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01410800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30930
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6247
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP20192
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: