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General NPI Number Information
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NPI Number | 1659431468
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Entity Type | Individual
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Provider Name | TIMOTHY BROWN DC
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 1458 BESSIE AVE
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City | TRACY
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State | CA
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Zip | 95376-3417
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Country | US
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Telephone | 209-835-6625
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Fax | 209-835-6871
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Provider Business Mailing Address
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Address Line | PO BOX 1124
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City | TRACY
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State | CA
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Zip | 95378-1124
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Country | US
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Telephone | 209-835-6625
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Fax | 209-835-6871
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 24295
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License Number State | CA
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