Provider Demographics
NPI:1285690545
Name:BROWN, WILLIAM CRAIG (PT, ATC, SCS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CRAIG
Last Name:BROWN
Suffix:
Gender:M
Credentials:PT, ATC, SCS
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 5924
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-5924
Mailing Address - Country:US
Mailing Address - Phone:480-488-9095
Mailing Address - Fax:480-488-2862
Practice Address - Street 1:18444 N 25TH AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-1261
Practice Address - Country:US
Practice Address - Phone:623-537-5600
Practice Address - Fax:866-939-2673
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ146457Medicaid
AZZ101161OtherMEDICARE