Healthcare Provider Details

I. General information

NPI: 1003032012
Provider Name (Legal Business Name): BROWN FAMILY CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1457 W EVANS ST
FLORENCE SC
29501-3390
US

IV. Provider business mailing address

1457 W EVANS ST
FLORENCE SC
29501-3390
US

V. Phone/Fax

Practice location:
  • Phone: 843-292-9873
  • Fax: 843-292-9875
Mailing address:
  • Phone: 843-292-9873
  • Fax: 843-292-9875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number2856
License Number StateSC

VIII. Authorized Official

Name: DR. DANA RENE BROWN
Title or Position: CHIROPRACTOR/OWNER
Credential: DC
Phone: 843-292-9873