Provider Demographics
NPI:1154035954
Name:BROWN, ERICA LIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LIN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8789 S REDWOOD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5742
Mailing Address - Country:US
Mailing Address - Phone:801-981-5977
Mailing Address - Fax:801-839-7190
Practice Address - Street 1:8789 S REDWOOD RD STE 100
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-5742
Practice Address - Country:US
Practice Address - Phone:801-981-5977
Practice Address - Fax:801-839-7190
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12907728-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist