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General NPI Number Information
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NPI Number | 1003163205
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Entity Type | Individual
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Provider Name | BRITTANY RENAE BROWN DPT
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Gender | Female
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 1615 CURLEW DR
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City | AMMON
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State | ID
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Zip | 83406-4718
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Country | US
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Telephone | 208-516-1204
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Fax | 208-577-6477
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Provider Business Mailing Address
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Address Line | 561 WAYSIDE PLZ
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-3830
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Country | US
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Telephone | 951-756-3745
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9959
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6787
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License Number State | ID
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