Provider Demographics
NPI:1215903232
Name:BROWN, JAKIE BRITT (ATC)
Entity type:Individual
Prefix:MR
First Name:JAKIE
Middle Name:BRITT
Last Name:BROWN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:325 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:DOUBLE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3042
Mailing Address - Country:US
Mailing Address - Phone:972-556-9992
Mailing Address - Fax:972-556-9993
Practice Address - Street 1:1 COWBOYS PKWY
Practice Address - Street 2:DALLAS COWBOYS
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4924
Practice Address - Country:US
Practice Address - Phone:972-556-9992
Practice Address - Fax:972-556-9993
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT09572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer