Provider Demographics
NPI:1427001999
Name:JANE BROWN, PT PC
Entity type:Organization
Organization Name:JANE BROWN, PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:641-782-8151
Mailing Address - Street 1:PO BOX 564
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-0564
Mailing Address - Country:US
Mailing Address - Phone:641-782-5052
Mailing Address - Fax:641-782-5721
Practice Address - Street 1:408 E TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-3958
Practice Address - Country:US
Practice Address - Phone:641-782-8151
Practice Address - Fax:641-782-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1427001999Medicaid
650015146OtherRR MEDICARE
650015146OtherRR MEDICARE