Provider Demographics
NPI:1871241141
Name:BROWN, BRIAN K
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MONTPELIER CT
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3413
Mailing Address - Country:US
Mailing Address - Phone:302-893-6930
Mailing Address - Fax:
Practice Address - Street 1:4040 FAIRFAX DR STE 120
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1613
Practice Address - Country:US
Practice Address - Phone:210-124-1077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-08-30
Deactivation Date:2022-07-25
Deactivation Code:
Reactivation Date:2022-08-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant