Provider Demographics
NPI:1275729022
Name:LISA S BROWN
Entity type:Organization
Organization Name:LISA S BROWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-420-0200
Mailing Address - Street 1:323 WILLIAMS ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3553
Mailing Address - Country:US
Mailing Address - Phone:410-420-0200
Mailing Address - Fax:410-420-2218
Practice Address - Street 1:323 WILLIAMS ST
Practice Address - Street 2:SUITE C
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3553
Practice Address - Country:US
Practice Address - Phone:410-420-0200
Practice Address - Fax:410-420-2218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01833BS111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU70843Medicare UPIN