Jonice Mariano Brown, PT
Individual provider Active NPI Physical Therapist · Hazelwood, MO
NPI 1689812752 · NPPES record last updated May 7, 2015
Key facts
- NPI
- 1689812752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2008008301 (MO)
- Practice address
- 745 Coach Light LN
Hazelwood, MO 63042-3426 - Phone
- (417) 773-5667
- NPI assigned
- Jan 28, 2009
- Sex
- Female
- 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 |
|---|---|---|---|
| 2008008301 | MO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2008008301 | MO | Yes |
Addresses
Primary practice location
745 Coach Light LN
Hazelwood, MO 63042-3426
Mailing address
745 Coach Light LN
Hazelwood, MO 63042-3426
Phone (417) 773-5667
Other providers in Hazelwood, MO
- Brothers Home Healthcare LLC
- Adrienne Brown
- Brittney Danielle Brown
- Crystal Brown
- Jonathan A. Brown
- Phillip Brown
- Brownridge Pediatrics After Hours P.C.
- Brownridge Pediatrics P.C.
- Earline Abigail Brownridge
- Seth Jonathan Brownridge
All providers in Hazelwood, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2015. 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.