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General NPI Number Information
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NPI Number | 1053593772
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Entity Type | Individual
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Provider Name | RYAN CHRISTOPHER BROWN DPT
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Gender | Male
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 4700 WISSAHICKON AVE SUITE 126
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4248
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Country | US
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Telephone | 215-951-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 46 W GOWEN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19119-1645
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Country | US
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Telephone | 302-252-5363
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Fax | 215-430-4108
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT018653
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License Number State | PA
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