Provider Demographics
NPI:1558388132
Name:BROWN, ANDY J (MS, CTRS)
Entity Type:Individual
Prefix:MR
First Name:ANDY
Middle Name:J
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS, CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 KIMLOUGH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-2622
Mailing Address - Country:US
Mailing Address - Phone:317-988-2760
Mailing Address - Fax:317-988-3312
Practice Address - Street 1:1481 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-2760
Practice Address - Fax:317-988-3312
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist