Provider Demographics
NPI:1235650938
Name:BROWN, SCHLONDA SUE (MSPT)
Entity Type:Individual
Prefix:
First Name:SCHLONDA
Middle Name:SUE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 OLD PENNY RD
Mailing Address - Street 2:
Mailing Address - City:VIRGIE
Mailing Address - State:KY
Mailing Address - Zip Code:41572-8392
Mailing Address - Country:US
Mailing Address - Phone:606-794-2417
Mailing Address - Fax:
Practice Address - Street 1:6800 US HIGHWAY 23 S STE 5
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3701
Practice Address - Country:US
Practice Address - Phone:606-639-1200
Practice Address - Fax:606-639-1020
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist