Provider Demographics
NPI:1508165028
Name:BROWN, GREGORY A (PTA)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 WHISPER HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7327
Mailing Address - Country:US
Mailing Address - Phone:719-637-3793
Mailing Address - Fax:
Practice Address - Street 1:3929 WHISPER HOLLOW DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7327
Practice Address - Country:US
Practice Address - Phone:719-637-3793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant