Provider Demographics
NPI:1104969013
Name:BROWN, HARRY E III (DC)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:E
Last Name:BROWN
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 E ORANGEBURG AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5335
Mailing Address - Country:US
Mailing Address - Phone:209-522-7222
Mailing Address - Fax:209-522-0806
Practice Address - Street 1:162 E ORANGEBURG AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5335
Practice Address - Country:US
Practice Address - Phone:209-522-7222
Practice Address - Fax:209-522-0806
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC170340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor