Individual
CHRISTINE BOMEISL BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 FORREST AVE, CARTERSVILLE, GA 30120-3640
(770) 382-3206
(770) 382-3276
Mailing address
1922 SADLER DR SE, SMYRNA, GA 30080-5815
(770) 426-5708
(770) 434-3999
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002476
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000835436A
PEACH STATE HEALTH PLAN
GA
05
—
000835436A
—
GA
01
—
10035959
AMERIGROUP
GA
01
—
312665
WELLCARE
GA
01
—
52825966 001
BLUE CROSS BLUE SHIELD
GA
01
—
52825966 002
BLUE CROSS BLUE SHIELD
GA
01
—
52825966 003
BLUE CROSS BLUE SHIELD
GA
Enumeration date
11/14/2006
Last updated
06/27/2011
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