Individual
LACIE L BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4204 CORAL PARK DR, BRUNSWICK, GA 31520-3016
(912) 280-9205
(912) 280-0022
Mailing address
PO BOX 949, ROME, GA 30162-0949
(706) 802-1991
(706) 802-1408
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008964
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008964
PHYSICAL THERAPY LISC#
GA
Enumeration date
02/15/2007
Last updated
04/17/2009
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