Healthcare Provider Details

I. General information

NPI: 1700855988
Provider Name (Legal Business Name): NICHOLE PARRIS BROWN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 11/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 GREENVILLE HWY
LYMAN SC
29365-1515
US

IV. Provider business mailing address

12301 GREENVILLE HWY
LYMAN SC
29365-1515
US

V. Phone/Fax

Practice location:
  • Phone: 864-949-9696
  • Fax: 864-949-9059
Mailing address:
  • Phone: 864-949-9696
  • Fax: 864-949-9059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2717
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: