Provider Demographics
NPI:1689020356
Name:BROWN, BARRETT LEIGH (DC)
Entity Type:Individual
Prefix:
First Name:BARRETT
Middle Name:LEIGH
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 LONGTOWN RD
Mailing Address - Street 2:STE F
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229
Mailing Address - Country:US
Mailing Address - Phone:803-699-0266
Mailing Address - Fax:803-699-7525
Practice Address - Street 1:921 LONGTOWN RD STE F
Practice Address - Street 2:ACTIVE LIFE CHIROPRACTIC & WELLNESS
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229
Practice Address - Country:US
Practice Address - Phone:803-699-0266
Practice Address - Fax:803-699-7525
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3685111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor