Provider Demographics
NPI:1275240699
Name:BROWN, SADIE LEE (LAT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:SADIE
Middle Name:LEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:IA
Mailing Address - Zip Code:50116-0125
Mailing Address - Country:US
Mailing Address - Phone:641-799-3305
Mailing Address - Fax:
Practice Address - Street 1:812 UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1999
Practice Address - Country:US
Practice Address - Phone:641-628-7665
Practice Address - Fax:641-628-6065
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0969402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer