Provider Demographics
NPI:1700868601
Name:BROWN, LINDA J (PT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 S CREEK DR
Mailing Address - Street 2:SUITE 116
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-9472
Mailing Address - Country:US
Mailing Address - Phone:606-348-3314
Mailing Address - Fax:606-348-3315
Practice Address - Street 1:1 S CREEK DR
Practice Address - Street 2:SUITE 116
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-9472
Practice Address - Country:US
Practice Address - Phone:606-348-3314
Practice Address - Fax:606-348-3315
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY000547225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87005476Medicaid
KY5027202Medicare ID - Type Unspecified
KY87005476Medicaid