MEDICARE: TONY BROWN

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	225200000X	Physical Therapy Assistant	2010016623	MO
2	225200000X	Physical Therapy Assistant	PTA0000006466	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PTA0000006466	OTHER	TN	TN BOARD OF HEALING ARTS

General Provider Information

NPI Number	:	1205372208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONY BROWN

Provider Business Mailing Address
First Line	:	301 N GRAYSON ST
Second Line	:
City	:	NEWBERN
State	:	TN
Zip	:	38059-1212
Country	:	US
Telephone Number	:	731-377-8918
Fax Number	:

Provider Business Practice Location Address
First Line	:	1084 E COUNTY HOME RD
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-8006
Country	:	US
Telephone Number	:	731-885-9065
Fax Number	:

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

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	08/07/2023

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Directions to “ TONY BROWN ” Practice Location

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