MEDICARE: JASON WAYNE BROWN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301009592	MI

General Provider Information

NPI Number	:	1689806499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON WAYNE BROWN D.C.

Provider Business Mailing Address
First Line	:	318 CENTER ST
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49445-3113
Country	:	US
Telephone Number	:	231-744-3332
Fax Number	:	231-744-5551

Provider Business Practice Location Address
First Line	:	318 CENTER ST
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49445-3113
Country	:	US
Telephone Number	:	231-744-3332
Fax Number	:	231-744-5551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2009
Last Update Date	:	08/12/2009

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