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General NPI Number Information
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NPI Number | 1477535607
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Entity Type | Individual
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Provider Name | RANDY M. BROWN M.P.T.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 2700 GREENUP AVE
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City | ASHLAND
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State | KY
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Zip | 41101-1953
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Country | US
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Telephone | 800-609-0905
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Fax | 800-609-0801
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Provider Business Mailing Address
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Address Line | 353 BLACKBURN AVE
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City | ASHLAND
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State | KY
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Zip | 41101-3479
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Country | US
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Telephone | 606-615-1774
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004537
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 010979
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License Number State | OH
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