Provider Demographics
NPI:1740392505
Name:BROWN, BRAD C (ATC)
Entity Type:Individual
Prefix:MR
First Name:BRAD
Middle Name:C
Last Name:BROWN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:460 GREAT CIRCLE RD
Mailing Address - Street 2:BAPTIST SPORTS PARK
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1404
Mailing Address - Country:US
Mailing Address - Phone:615-565-4088
Mailing Address - Fax:615-565-4092
Practice Address - Street 1:460 GREAT CIRCLE RD
Practice Address - Street 2:BAPTIST SPORTS PARK
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1404
Practice Address - Country:US
Practice Address - Phone:615-565-4088
Practice Address - Fax:615-565-4092
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000003482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer