Provider Demographics
NPI:1477574952
Name:BROWN, JAMES WESLEY (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WESLEY
Last Name:BROWN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S COLLEGE RD
Mailing Address - Street 2:ATHLETIC TRAINING
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3201
Mailing Address - Country:US
Mailing Address - Phone:910-962-3584
Mailing Address - Fax:910-962-3002
Practice Address - Street 1:601 S COLLEGE RD
Practice Address - Street 2:ATHLETIC TRAINING
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3201
Practice Address - Country:US
Practice Address - Phone:910-962-3584
Practice Address - Fax:910-962-3002
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer