Provider Demographics
NPI:1376662684
Name:BROWN, ROBERT BARNETT (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BARNETT
Last Name:BROWN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5267 THOMAS JEFFERSON RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2377
Mailing Address - Country:US
Mailing Address - Phone:434-386-6007
Mailing Address - Fax:
Practice Address - Street 1:MADISON HEIGHTS
Practice Address - Street 2:CENTRAL VIRGINIA TRAINING CENTER
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501
Practice Address - Country:US
Practice Address - Phone:434-947-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist