Provider Demographics
NPI:1013014182
Name:BROWER, JOAN LORRIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:LORRIE
Last Name:BROWER
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 1:1023 MAIN PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-1170
Mailing Address - Country:US
Mailing Address - Phone:636-639-8944
Mailing Address - Fax:636-639-8922
Practice Address - Street 1:1023 MAIN PLAZA DR
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-1170
Practice Address - Country:US
Practice Address - Phone:636-639-8944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO5874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000032039Medicare ID - Type Unspecified