Healthcare Provider Details
I. General information
NPI: 1376925909
Provider Name (Legal Business Name): ALYX BROWN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/19/2015
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3000 CENTER GREEN DR STE 130
BOULDER CO
80301-2364
US
IV. Provider business mailing address
3000 CENTER GREEN DR STE 130
BOULDER CO
80301-2364
US
V. Phone/Fax
- Phone: 303-444-5105
- Fax:
- Phone: 303-444-5105
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | CHR.0007297 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: