MEDICARE: MINDY MARIE BROWN DC

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	2007015880	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4102425	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1922023423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINDY MARIE BROWN DC

Provider Business Mailing Address
First Line	:	4020 BALTIMORE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2257
Country	:	US
Telephone Number	:	816-561-1500
Fax Number	:	816-561-1565

Provider Business Practice Location Address
First Line	:	4020 BALTIMORE AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2257
Country	:	US
Telephone Number	:	816-561-1500
Fax Number	:	816-561-1565

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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Directions to “ MINDY MARIE BROWN DC” Practice Location

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