Provider Demographics
NPI:1568794956
Name:BROWN, DALE RIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:RIE
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 1:1715 WILMA RUDOLPH BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6861
Mailing Address - Country:US
Mailing Address - Phone:419-733-3209
Mailing Address - Fax:
Practice Address - Street 1:1715 WILMA RUDOLPH BLVD STE E
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6861
Practice Address - Country:US
Practice Address - Phone:419-733-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2390111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor