Provider Demographics
NPI:1275687295
Name:BROWN, ANDREW WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WILLIAM
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2508 COUNTY ROAD I APT 102
Mailing Address - Street 2:
Mailing Address - City:MOUNDS VIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6228
Mailing Address - Country:US
Mailing Address - Phone:218-591-4801
Mailing Address - Fax:763-785-4172
Practice Address - Street 1:12203 ABERDEEN ST NE # 140
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4719
Practice Address - Country:US
Practice Address - Phone:763-785-4120
Practice Address - Fax:763-785-4172
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor