Healthcare Provider Details

I. General information

NPI: 1013377266
Provider Name (Legal Business Name): TANYA BROWN PT, DPT, NCS, GCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TANYA TEPEN

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 BUTLER HILL RD
SAINT LOUIS MO
63128-4152
US

IV. Provider business mailing address

5300 BUTLER HILL RD
SAINT LOUIS MO
63128-4152
US

V. Phone/Fax

Practice location:
  • Phone: 314-842-0588
  • Fax:
Mailing address:
  • Phone: 314-842-0588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070022017
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2016005644
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: