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General NPI Number Information
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NPI Number | 1225244932
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Entity Type | Individual
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Provider Name | MELISSA GILBERT BROWN P.T.A.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1501 RIVERSIDE DR STE 270
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City | CHATTANOOGA
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State | TN
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Zip | 37406-4309
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Country | US
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Telephone | 423-778-3196
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Fax | 423-778-6197
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Provider Business Mailing Address
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Address Line | 2149 N MARBLE TOP RD
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City | CHICKAMAUGA
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State | GA
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Zip | 30707-2037
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Country | US
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Telephone | 706-375-6482
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 0000003603
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License Number State | TN
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