Tosha Brown

Individual provider Active NPI Physical Therapy Assistant · McComb, MS

NPI 1003062324 · NPPES record last updated Aug 18, 2008

Key facts

NPI
1003062324
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA5274 (AL)
Practice address
206 Maryland Ave
McComb, MS 39648-3926
Phone
(601) 250-4815
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA5274ALMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA5274 AL Yes

Addresses

Primary practice location

206 Maryland Ave
McComb, MS 39648-3926

Mailing address

8029 Copperfield Dr
Montgomery, AL 36117-7310

Other providers in McComb, MS

All providers in McComb, MS · Physical Therapy Assistant in Mississippi

Sources for this page

Verify at the official NPI Registry.