MEDICARE: DR. COREY 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	DC010985	PA
2	111N00000X	Chiropractor	AJ010758	PA

General Provider Information

NPI Number	:	1801286273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COREY BROWN D.C.

Provider Business Mailing Address
First Line	:	19 DORMAN RD
Second Line	:
City	:	WHEELING
State	:	WV
Zip	:	26003-6374
Country	:	US
Telephone Number	:	304-639-8338
Fax Number	:

Provider Business Practice Location Address
First Line	:	1704 BROADVIEW BLVD
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-2123
Country	:	US
Telephone Number	:	724-230-0255
Fax Number	:

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

Provider Enumeration Date	:	01/23/2015
Last Update Date	:	01/23/2015

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