Individual
MARK TERRY BROWN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 845-3677
Mailing address
613 WHITFIELD RD, HOGANSVILLE, GA 30230-3211
(706) 845-8938
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002040
GA
Other
Enumeration date
01/31/2006
Last updated
07/08/2007
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