Healthcare Provider Details

I. General information

NPI: 1831887264
Provider Name (Legal Business Name): MARISA BROWN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 S HIGH ST
COLUMBUS OH
43207-4083
US

IV. Provider business mailing address

3700 S HIGH ST
COLUMBUS OH
43207-4083
US

V. Phone/Fax

Practice location:
  • Phone: 614-365-5229
  • Fax:
Mailing address:
  • Phone: 614-365-5229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number012713
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: