Healthcare Provider Details

I. General information

NPI: 1225019656
Provider Name (Legal Business Name): ROD C BROWN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7092A SUMMERFIELD RD
SUMMERFIELD NC
27358-9412
US

IV. Provider business mailing address

7092A SUMMERFIELD RD
SUMMERFIELD NC
27358-9412
US

V. Phone/Fax

Practice location:
  • Phone: 336-644-1112
  • Fax: 336-644-1118
Mailing address:
  • Phone: 336-644-1112
  • Fax: 336-644-1118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2482
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: