Provider Demographics
NPI:1326344888
Name:BROWN, ERICA LYN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LYN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2334
Mailing Address - Country:US
Mailing Address - Phone:740-593-8787
Mailing Address - Fax:740-592-5989
Practice Address - Street 1:603 W UNION ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2334
Practice Address - Country:US
Practice Address - Phone:740-593-8787
Practice Address - Fax:740-592-5989
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07627225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant