Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2306606010 | VA |
NPI | 1013679901 |
---|---|
Provider Name | Miss Jaimie Alison Brown |
First Address | Newport News, VA 23602-9120 |
Second Address | Hampton, VA 23666-6263 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2021 |
Last Update Date | 08/10/2021 |