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Individual

MISS AMY BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, PTA, CSCS

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
19726
OR
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19726
LMT
OR
01
7247825326
CERTIFIED STRENGTH & CONDITIONING SPECIALIST
01
8072
LICENSE #
OR
Enumeration date
08/30/2006
Last updated
10/21/2013
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