Basic Information
| Provider Information | |||||||||
| NPI: | 1710179015 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | CHRISI | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 88 STANDISH RD | ||||||||
| Address2: | |||||||||
| City: | HAVERHILL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018322935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783733535 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2250 HICKORY RD | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | PLYMOUTH MEETING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194621047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008794471 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2007 | ||||||||
| LastUpdateDate: | 08/10/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 4845 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.