Provider Demographics
NPI:1336144690
Name:BROWN, CHRISTOPHER ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ROBERT
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:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:NORTH TAZEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:24630-0476
Mailing Address - Country:US
Mailing Address - Phone:276-988-4265
Mailing Address - Fax:276-988-4152
Practice Address - Street 1:699 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTH TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24630-9577
Practice Address - Country:US
Practice Address - Phone:276-988-4265
Practice Address - Fax:276-988-4152
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC07070Medicare PIN