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NPI Code Detail

MEDICARE: EMMA BROWN MS, ATC

MEDICARE:   EMMA  BROWN  MS, ATC
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
1390200000XStudent in an Organized Health Care Education/Training Program
22255A2300XAthletic Trainer36003633AIN

General Provider Information

NPI Number : 1376016071
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA BROWN MS, ATC
Provider Business Mailing Address
First Line : 1314 NEWTON PL
Second Line :
City : MARSHALL
State : IL
Zip : 62441-5323
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1314 NEWTON PL
Second Line :
City : MARSHALL
State : IL
Zip : 62441-5323
Country : US
Telephone Number : 586-259-0595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2019
Last Update Date : 06/17/2025

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Directions to “ EMMA BROWN MS, ATC” Practice Location

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