Healthcare Provider Details

I. General information

NPI: 1972335800
Provider Name (Legal Business Name): MARTINA BRITTANY BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 WADE PARK AVE
CLEVELAND OH
44103-2969
US

IV. Provider business mailing address

8303 WADE PARK AVE
CLEVELAND OH
44103-2969
US

V. Phone/Fax

Practice location:
  • Phone: 216-835-1324
  • Fax:
Mailing address:
  • Phone: 216-835-1324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: