Provider Demographics
NPI:1558960641
Name:NICHOLAS L. BROWN CHIROPRACTIC, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:NICHOLAS L. BROWN CHIROPRACTIC, A PROFESSIONAL CORPORATION
Other - Org Name:THRIVE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-617-0618
Mailing Address - Street 1:6509 E SERRANO AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-5049
Mailing Address - Country:US
Mailing Address - Phone:714-363-3821
Mailing Address - Fax:714-363-3831
Practice Address - Street 1:6509 E SERRANO AVE STE A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-5049
Practice Address - Country:US
Practice Address - Phone:714-363-3821
Practice Address - Fax:714-363-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty