Individual
CORY BRANDON BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., A.T.C., L.A.T.
Contact information
Practice address
3401 YORKSHIRE MEDICAL PARK, LEXINGTON, KY 40509-2513
(859) 263-5140
Mailing address
1295 GAINESWAY DR, LEXINGTON, KY 40517-2816
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003304
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096.003304
IL STATE LICENSE
IL
01
—
1021710
NATA
—
01
—
2000001929
BOC ATC
—
Enumeration date
05/19/2012
Last updated
08/30/2019
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