Provider Demographics
NPI:1730481391
Name:BROWN, ROBERT ELMER (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ELMER
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 1:1706 10TH ST E
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336-2514
Mailing Address - Country:US
Mailing Address - Phone:320-864-3196
Mailing Address - Fax:320-864-3197
Practice Address - Street 1:8000 ROSE
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:MN
Practice Address - Zip Code:55386
Practice Address - Country:US
Practice Address - Phone:952-443-3710
Practice Address - Fax:952-443-3761
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor