Individual
MRS. TONJA JEAN BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1001 N 7TH AVE STE 280, POCATELLO, ID 83201-5788
(208) 239-1490
(208) 239-1794
Mailing address
1001 N 7TH AVE STE 205, POCATELLO, ID 83201-5761
(208) 239-1490
(208) 239-1794
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
OT-838
ID
225X00000X
Occupational Therapist
Primary
OT-838
ID
Other
Enumeration date
06/28/2022
Last updated
09/19/2024
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