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NPI Code Detail

MEDICARE: MR. PAUL S BROWN COTA/L

MEDICARE:  MR. PAUL S BROWN  COTA/L
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
1224Z00000XOccupational Therapy Assistant2248TN
2224Z00000XOccupational Therapy Assistant268531KY

General Provider Information

NPI Number : 1831526904
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL S BROWN COTA/L
Provider Business Mailing Address
First Line : 1355 BARDSTOWN RD # 300
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1353
Country : US
Telephone Number : 601-926-8407
Fax Number :
Provider Business Practice Location Address
First Line : 6301 BASS RD
Second Line :
City : PROSPECT
State : KY
Zip : 40059-9384
Country : US
Telephone Number : 502-228-8359
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2013
Last Update Date : 09/01/2021

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Directions to “ MR. PAUL S BROWN COTA/L” Practice Location

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