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General NPI Number Information
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NPI Number | 1033531603
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Entity Type | Individual
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Provider Name | JUSTIN BROWN DPT
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Gender | Male
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 06/17/2019
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Provider Practice Location Address
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Address Line | 1775 ALYSHEBA WAY STE 10
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City | LEXINGTON
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State | KY
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Zip | 40509-2479
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Country | US
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Telephone | 859-260-4540
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Fax | 859-260-4545
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Provider Business Mailing Address
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Address Line | 2700 STANLEY GAULT PKWY STE 129
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City | LOUISVILLE
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State | KY
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Zip | 40223-5176
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Country | US
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Telephone | 502-253-4914
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Fax | 502-489-5751
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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 | 006313
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License Number State | KY
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