Brown, Amanda M

Brown, Amanda M is an individual health care provider with primary practice located at 605 N 12Th St , Mount Vernon IL 62864-2857. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Brown, Amanda M can be contacted via phone (618) 436-8640.

Contact Information

Primary practice address
605 N 12Th St Mount Vernon IL 62864-2857
Phone: (618) 436-8640
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070013466 Illinois

Profile Details

NPI number 1659416923
LBN Legal business name Brown, Amanda M
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Nov 15th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659416923 NPPES
Illinois Other 070013466 STATE LICENSE NUMBER

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