Provider Demographics
NPI:1962003061
Name:BROWN, TAWIONA (DPT)
Entity Type:Individual
Prefix:DR
First Name:TAWIONA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24559 MCCUTCHEONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-9665
Mailing Address - Country:US
Mailing Address - Phone:419-250-4298
Mailing Address - Fax:
Practice Address - Street 1:20311 PEMBERVILLE RD
Practice Address - Street 2:
Practice Address - City:PEMBERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43450-9413
Practice Address - Country:US
Practice Address - Phone:866-244-4180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT0082782251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic