MEDICARE: MS. JANICE LOUISE 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	3633	TN

General Provider Information

NPI Number	:	1366160301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANICE LOUISE BROWN

Provider Business Mailing Address
First Line	:	709 E 2ND NORTH ST
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-6612
Country	:	US
Telephone Number	:	423-231-4958
Fax Number	:

Provider Business Practice Location Address
First Line	:	709 E 2ND NORTH ST
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-6612
Country	:	US
Telephone Number	:	423-231-4958
Fax Number	:

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

Provider Enumeration Date	:	08/16/2022
Last Update Date	:	08/16/2022

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