Healthcare Provider Details

I. General information

NPI: 1073673935
Provider Name (Legal Business Name): LORI ANN BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 CHURCH ST MEDICAL PLAZA 2 SUITE 106
NASHVILLE TN
37203-2021
US

IV. Provider business mailing address

2021 CHURCH ST MEDICAL PLAZA 2 SUITE 106
NASHVILLE TN
37203-2021
US

V. Phone/Fax

Practice location:
  • Phone: 615-342-0246
  • Fax: 615-342-0213
Mailing address:
  • Phone: 615-342-0246
  • Fax: 615-342-0213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: