Provider Demographics
NPI:1760657829
Name:BROWN CHIROPRACTIC CENTER PLLC
Entity Type:Organization
Organization Name:BROWN CHIROPRACTIC CENTER PLLC
Other - Org Name:MERVIN KEITH BROWN
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MERVIN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-263-2833
Mailing Address - Street 1:824 W MAUMEES ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221
Mailing Address - Country:US
Mailing Address - Phone:517-263-2833
Mailing Address - Fax:517-265-9340
Practice Address - Street 1:824 W MAUMEE ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221
Practice Address - Country:US
Practice Address - Phone:517-263-2833
Practice Address - Fax:517-265-9340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMB00260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950D65014OtherBCBS
MI04679OtherPARAMOUNT
MIT3306Medicare UPIN
MI04679OtherPARAMOUNT