MEDICARE: MR. TIMOTHY BROWN P.T, D.P.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT021174	PA

General Provider Information

NPI Number	:	1114216827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY BROWN P.T, D.P.T

Provider Business Mailing Address
First Line	:	2311 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1007
Country	:	US
Telephone Number	:	215-331-3414
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1007
Country	:	US
Telephone Number	:	215-331-3414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	04/04/2011

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Directions to “ MR. TIMOTHY BROWN P.T, D.P.T” Practice Location

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