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General NPI Number Information
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NPI Number | 1942005129
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Entity Type | Individual
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Provider Name | NOLA GRACE BROWN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 3151 APEX DR STE 101D
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City | CHARLOTTE
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State | NC
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Zip | 28211-2179
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Country | US
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Telephone | 980-224-7958
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Fax |
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Provider Business Mailing Address
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Address Line | 1348 SWEET PEA ST
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City | MONROE
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State | NC
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Zip | 28110-7177
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Country | US
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Telephone | 919-455-8677
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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 | P23824
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License Number State | NC
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