Provider Demographics
NPI:1467291187
Name:BROWN, LYNN THERESA (PT, DPT)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:THERESA
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11240 BRANDER DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-8558
Mailing Address - Country:US
Mailing Address - Phone:225-916-7660
Mailing Address - Fax:
Practice Address - Street 1:11140 N HARRELLS FERRY RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8307
Practice Address - Country:US
Practice Address - Phone:225-272-0150
Practice Address - Fax:225-275-0930
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11753225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist