Provider Demographics
NPI:1588106520
Name:BROWN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BROWN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-476-5589
Mailing Address - Street 1:312 W 4TH STREET
Mailing Address - Street 2:BROWN CHIROPRACTIC, LLC
Mailing Address - City:APPLETON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64724
Mailing Address - Country:US
Mailing Address - Phone:660-476-5589
Mailing Address - Fax:660-476-5749
Practice Address - Street 1:312 W. 4TH STREET
Practice Address - Street 2:
Practice Address - City:APPLETON CITY
Practice Address - State:MO
Practice Address - Zip Code:64724
Practice Address - Country:US
Practice Address - Phone:660-476-5589
Practice Address - Fax:660-476-5749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0007742OtherP-TAN