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NPI 1659136588

NPI 1659136588 : PEYTON RYAN BROWN OTR/L : BIRMINGHAM, AL

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General NPI Number Information
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    NPI Number           |    1659136588
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    Entity Type          |    Individual 
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    Provider Name        |    PEYTON RYAN BROWN OTR/L
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/20/2024
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    Last Update Date     |    02/20/2024
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Provider Practice Location Address
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    Address Line         |    700 19TH ST S 
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    City                 |    BIRMINGHAM
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    State                |    AL
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    Zip                  |    35233-1927
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    Country              |    US
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    Telephone            |    205-933-8101
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1501 15TH AVE S APT 21 
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    City                 |    BIRMINGHAM
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    State                |    AL
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    Zip                  |    35205-5423
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    Country              |    US
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    Telephone            |    334-704-3136
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    6348
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    License Number State |    AL
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