Provider Demographics
NPI:1497132161
Name:BROWN, ELISA DEANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:DEANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9287 BATTLE RD
Mailing Address - Street 2:
Mailing Address - City:ETHEL
Mailing Address - State:LA
Mailing Address - Zip Code:70730-4012
Mailing Address - Country:US
Mailing Address - Phone:225-978-8799
Mailing Address - Fax:
Practice Address - Street 1:2301 SEVERN AVE
Practice Address - Street 2:B309
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1949
Practice Address - Country:US
Practice Address - Phone:225-978-8799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-01
Last Update Date:2015-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics