Doctor Name: | DR. IRA JASON BROWN |
NPI Number: | 1619230489 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 2012016550 |
Business Practice Address: | 850 E San Martin St Bolivar, MO - 656132897 |
Business Phone Number: | 4177772888 |
Business Fax Number: | |
Mailing Address: | 4077 S 97th Rd, BOLIVAR |
State: | MO |
Postal Code: | 656138512 |
Phone Number: | 4177775865 |
Fax Number: | |
NPI Enumeration Date: | 06/18/2012 |
NPI Last Update Date: | 06/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 2012016550 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |