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General NPI Number Information
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NPI Number | 1114980877
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Entity Type | Individual
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Provider Name | GLENN BROWN PT
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Gender | Male
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 06/20/2014
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Provider Practice Location Address
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Address Line | 1255 S STATE ST SUITE 7
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City | DOVER
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State | DE
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Zip | 19901-6932
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Country | US
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Telephone | 302-423-0236
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Fax |
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Provider Business Mailing Address
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Address Line | 71 MCBRY DR
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City | DOVER
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State | DE
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Zip | 19901-4407
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Country | US
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Telephone | 302-423-0236
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | J10000429
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | J10000429
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | J10000429
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | J10000429
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | J3-0000041
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License Number State | DE
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