MEDICARE: BROWN FAMILY CHIROPRACTIC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301009592	MI

General Provider Information

NPI Number	:	1306079009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWN FAMILY CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	318 CENTER ST
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49445-3113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 CENTER ST
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49445-3113
Country	:	US
Telephone Number	:	231-744-3332
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTIC/OWNER
Name	:	JASON BROWN
Credential	:	D.C.
Telephone Number	:	231-744-3332

Provider Enumeration Date	:	08/27/2009
Last Update Date	:	08/27/2009

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