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General NPI Number Information
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NPI Number | 1013181098
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Entity Type | Individual
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Provider Name | KELLY JO BROWN L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 04/21/2008
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Last Update Date | 04/21/2008
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Provider Practice Location Address
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Address Line | 1583 VICTOR RD NW
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City | LANCASTER
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State | OH
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Zip | 43130-8039
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Country | US
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Telephone | 740-653-5390
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Fax | 740-653-2808
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Provider Business Mailing Address
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Address Line | 6966 BADGER DR
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City | CANAL WINCHESTER
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State | OH
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Zip | 43110-1333
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Country | US
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Telephone | 614-829-3559
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 33.015136
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License Number State | OH
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