Provider Demographics
NPI:1366012940
Name:BROWN, ADAM J (DC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:J
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 1:180 DEBBIE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-7611
Mailing Address - Country:US
Mailing Address - Phone:608-344-1182
Mailing Address - Fax:
Practice Address - Street 1:S71W23325 NATIONAL AVE STE 5
Practice Address - Street 2:
Practice Address - City:BIG BEND
Practice Address - State:WI
Practice Address - Zip Code:53103-9495
Practice Address - Country:US
Practice Address - Phone:262-662-9775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5619-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor