Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT011670 | OH |
NPI | 1003188632 |
---|---|
Provider Name | Ms. Kristen Leigh Brown |
First Address | Westlake, OH 44145-4600 |
Second Address | Westlake, OH 44145-4033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2012 |
Last Update Date | 27/01/2012 |