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Individual

CECELIA ANNITA BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
7900 AIRWAYS BLVD, BLDG A, STE 2, SOUTHAVEN, MS 38671-4113
(662) 536-4096
(662) 536-4099
Mailing address
7900 AIRWAYS BLVD, BLDG A, STE 2, SOUTHAVEN, MS 38671-4113
(662) 536-4096
(662) 536-4099

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4256
MS
225100000X
Physical Therapist
PT7658
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0183838
BLUE CROSS PROVIDER NUMBE
TN
Enumeration date
02/27/2007
Last updated
02/25/2008
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