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General NPI Number Information
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NPI Number | 1346367679
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Entity Type | Organization
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Legal Business Name | BROWN CHIROPRACTIC CLINIC PA
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 2101 W MAIN ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-2757
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Country | US
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Telephone | 479-968-1181
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Fax | 479-967-7279
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Provider Business Mailing Address
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Address Line | 2101 W MAIN ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-2757
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Country | US
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Telephone | 479-968-1181
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Fax | 479-967-7279
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIKEL R BROWN
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Credential | D.C.
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Telephone | 479-968-1181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 897
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License Number State | AR
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