Bethany Brown
Individual provider Active NPI Physical Therapist · Camby, IN
NPI 1194437418 · NPPES record last updated Aug 1, 2024
Key facts
- NPI
- 1194437418
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 05013993A (IN)
- Practice address
- 10701 Alliance Dr Ste D
Camby, IN 46113-8837 - Phone
- (317) 821-3740
- Fax
- (317) 821-3750
- NPI assigned
- Dec 19, 2022
- Reactivated
- Aug 1, 2024
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 05013993A | IN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05013993A | IN | Yes |
Addresses
Primary practice location
10701 Alliance Dr Ste D
Camby, IN 46113-8837
Mailing address
10701 Alliance Dr Ste D
Camby, IN 46113-8837
Phone (317) 821-3740
Other providers in Camby, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.