Provider Demographics
NPI:1013094960
Name:BROWN, ARNOLD L (PT)
Entity type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-3221
Mailing Address - Country:US
Mailing Address - Phone:252-535-4809
Mailing Address - Fax:252-535-1040
Practice Address - Street 1:114 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-3221
Practice Address - Country:US
Practice Address - Phone:252-535-4809
Practice Address - Fax:252-535-1040
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7201008Medicaid
NC7201037Medicaid
NC7201008Medicaid