Provider Demographics
NPI:1154626026
Name:BROWN, KELLI LYNN (DC)
Entity type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-3005
Mailing Address - Country:US
Mailing Address - Phone:319-653-3336
Mailing Address - Fax:866-735-0977
Practice Address - Street 1:1108 W 5TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-3005
Practice Address - Country:US
Practice Address - Phone:319-653-3336
Practice Address - Fax:866-735-0977
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor