Provider Demographics
NPI:1992750202
Name:HOLTON-BROWN, MONISA SUZANNE (DC)
Entity type:Individual
Prefix:DR
First Name:MONISA
Middle Name:SUZANNE
Last Name:HOLTON-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 1:2500 18TH ST
Mailing Address - Street 2:STE 102
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3282
Mailing Address - Country:US
Mailing Address - Phone:309-283-7316
Mailing Address - Fax:309-283-7315
Practice Address - Street 1:2500 18TH ST
Practice Address - Street 2:STE 102
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3282
Practice Address - Country:US
Practice Address - Phone:309-283-7316
Practice Address - Fax:309-283-7315
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06431111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0008115279OtherBLUE CROSS BLUE SHIELD IL
IL038009444Medicaid
IA06988OtherBLUE CROSS BLUE SHIELD
IAU86976Medicare UPIN
ILU86976Medicare UPIN
IL038009444Medicaid
IA06988OtherBLUE CROSS BLUE SHIELD