Provider Demographics
NPI:1326026725
Name:BROWN, BRIAN JAMES (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 WEST ST
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-2358
Mailing Address - Country:US
Mailing Address - Phone:641-236-5743
Mailing Address - Fax:641-236-8657
Practice Address - Street 1:304 WEST ST
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2358
Practice Address - Country:US
Practice Address - Phone:641-236-5743
Practice Address - Fax:641-236-8657
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4937111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA21147OtherBCBS OF IOWA
IA21147OtherBCBS OF IOWA
IAI0821Medicare ID - Type Unspecified