Healthcare Provider Details

I. General information

NPI: 1487704367
Provider Name (Legal Business Name): NICHOLAS BROWN DC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2704 DELTA OAKS DR
EUGENE OR
97408-1740
US

IV. Provider business mailing address

2704 DELTA OAKS DR
EUGENE OR
97408-1740
US

V. Phone/Fax

Practice location:
  • Phone: 541-484-0360
  • Fax: 541-484-9036
Mailing address:
  • Phone: 541-484-0360
  • Fax: 541-484-9036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number272883
License Number StateOR

VIII. Authorized Official

Name: NICHOLAS RYAN BROWN
Title or Position: BUSINESS OWNER
Credential: DC
Phone: 541-484-0360