Provider Demographics
NPI:1245557750
Name:BROWN, BRIDGETTE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIDGETTE
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:BRIDGETTE
Other - Middle Name:ANN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:124 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BRANDENBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40108-1271
Mailing Address - Country:US
Mailing Address - Phone:270-422-5553
Mailing Address - Fax:270-422-5543
Practice Address - Street 1:124 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1271
Practice Address - Country:US
Practice Address - Phone:270-422-5553
Practice Address - Fax:270-422-5543
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor