Provider Demographics
NPI:1417262254
Name:BROWN, MICHAEL A (CMT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11717 GOLD PARKE LN
Mailing Address - Street 2:
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-8351
Mailing Address - Country:US
Mailing Address - Phone:916-384-8608
Mailing Address - Fax:916-852-1514
Practice Address - Street 1:8680 GREENBACK LN
Practice Address - Street 2:SUITE 110
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-3969
Practice Address - Country:US
Practice Address - Phone:916-384-8608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist