Provider Demographics
NPI:1326223314
Name:BROWN CHIROPRACTIC CLINIC PC
Entity type:Organization
Organization Name:BROWN CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PURPURA
Authorized Official - Suffix:
Authorized Official - Credentials:BS DC
Authorized Official - Phone:770-887-7234
Mailing Address - Street 1:1330 ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-6406
Mailing Address - Country:US
Mailing Address - Phone:770-887-7234
Mailing Address - Fax:770-887-7239
Practice Address - Street 1:1330 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-6406
Practice Address - Country:US
Practice Address - Phone:770-887-7234
Practice Address - Fax:770-887-7239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA2140261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty