Chad Raymond Brown, PTA
Individual provider Active NPI Physical Therapy Assistant · Sissonville, WV
NPI 1619299476 · NPPES record last updated Feb 22, 2010
Key facts
- NPI
- 1619299476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 913 (WV)
- Practice address
- 302 Cedar Ridge Rd
Sissonville, WV 25320-9502 - Phone
- (304) 984-0046
- NPI assigned
- Feb 22, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 913 | WV | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 913 | WV | Yes |
Addresses
Primary practice location
302 Cedar Ridge Rd
Sissonville, WV 25320-9502
Mailing address
302 Cedar Ridge Rd
Sissonville, WV 25320-9502
Phone (304) 984-0046
Other providers in Sissonville, WV
- 302 Cedar Ridge Road Operations LLC
- Ashley Nicole Alls
- James Edwin Black
- Jeffery Todd Black
- Megan E Bowman
- Cabin Creek Health Center Inc
- Cedar Ridge Center Opco, LLC
- Kelly Renee Cottrell
- Hannah R Crader
- Tonya M Criser
All providers in Sissonville, WV · Physical Therapy Assistant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2010. 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.