Provider Demographics
NPI:1255681250
Name:BROWN, DEBORAH GRACE BROCKWAY (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:GRACE BROCKWAY
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:GRACE
Other - Last Name:BROCKWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-2218
Mailing Address - Country:US
Mailing Address - Phone:785-242-2386
Mailing Address - Fax:
Practice Address - Street 1:121 W 3RD ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-2218
Practice Address - Country:US
Practice Address - Phone:785-242-2386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor