Individual
DR. IRA JASON BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
850 E SAN MARTIN ST, BOLIVAR, MO 65613-2897
(417) 777-2888
Mailing address
4077 S 97TH RD, BOLIVAR, MO 65613-8512
(417) 777-5865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2012016550
MO
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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