MEDICARE: DR. LYNDA SANDERS-BROWN D.C.

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	2301008985	MI

General Provider Information

NPI Number	:	1598989899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNDA SANDERS-BROWN D.C.

Provider Business Mailing Address
First Line	:	2858 PINE GROVE AVE
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-1971
Country	:	US
Telephone Number	:	810-824-4391
Fax Number	:

Provider Business Practice Location Address
First Line	:	2858 PINE GROVE AVE
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-1971
Country	:	US
Telephone Number	:	810-824-4391
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	05/02/2012

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