Basic Information
| Provider Information | |||||||||
| NPI: | 1053897470 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | CINDY | ||||||||
| MiddleName: | CHWALIE | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16944 TOPEKA CIR | ||||||||
| Address2: | |||||||||
| City: | CHOCTAW | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730205916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4059904037 | ||||||||
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| Practice Location | |||||||||
| Address1: | 921 NE 13TH ST | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054563905 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2018 | ||||||||
| LastUpdateDate: | 07/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 2930 | OK | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.