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General NPI Number Information
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NPI Number | 1902858632
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Entity Type | Organization
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Legal Business Name | BROWN PHYSICAL THERAPY SERVICE
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 121 HOSPITAL DR
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City | SALEM
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State | KY
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Zip | 42078-8043
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Country | US
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Telephone | 270-988-7213
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Fax | 270-988-2199
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Provider Business Mailing Address
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Address Line | 139 HIGHLAND DR
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City | MADISONVILLE
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State | KY
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Zip | 42431-9154
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Country | US
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Telephone | 270-825-2158
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Fax | 270-825-1277
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR PT
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Name | MR. GARY HAMILTON BROWN
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Credential | PT
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Telephone | 270-988-7213
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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 | 000361
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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 | 002095
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 002363
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License Number State | KY
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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 | 000477
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 000360
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License Number State | KY
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