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General NPI Number Information
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NPI Number | 1730604307
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Entity Type | Individual
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Provider Name | JEREMY BROWN DPT
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Gender | Male
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 24165 W INTERSTATE 10 STE 202
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1160
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Country | US
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Telephone | 210-698-1919
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Fax | 210-698-6919
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Provider Business Mailing Address
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Address Line | 646 GEORGE ST
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City | CLARE
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State | MI
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Zip | 48617-9413
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Country | US
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Telephone | 989-424-6300
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Fax | 989-424-6302
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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 | 1293285
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License Number State | TX
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