Provider Demographics
NPI:1689734303
Name:BROWN, JONATHAN ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
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 1:235 ST JOHNS RD
Mailing Address - Street 2:SUITE 40
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-8334
Mailing Address - Country:US
Mailing Address - Phone:828-681-5454
Mailing Address - Fax:828-681-5054
Practice Address - Street 1:235 ST JOHNS RD
Practice Address - Street 2:SUITE 40
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-8334
Practice Address - Country:US
Practice Address - Phone:828-681-5454
Practice Address - Fax:828-681-5054
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3392111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor