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General NPI Number Information
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NPI Number | 1073725180
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Entity Type | Individual
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Provider Name | MICHAEL ALLEN BROWN ATC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1128 E WEISGARBER RD
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City | KNOXVILLE
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State | TN
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Zip | 37909-2674
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Country | US
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Telephone | 865-558-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 254 DOE RUN BLVD
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City | CLINTON
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State | TN
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Zip | 37716-6620
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Country | US
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Telephone | 865-680-7964
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 288
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License Number State | TN
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