Provider Demographics
NPI:1790846723
Name:BROWN-JAMES, MARLA LEA (DC)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:LEA
Last Name:BROWN-JAMES
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 1:312 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64724-1406
Mailing Address - Country:US
Mailing Address - Phone:660-476-5589
Mailing Address - Fax:660-476-5749
Practice Address - Street 1:312 W 4TH ST
Practice Address - Street 2:
Practice Address - City:APPLETON CITY
Practice Address - State:MO
Practice Address - Zip Code:64724-1406
Practice Address - Country:US
Practice Address - Phone:660-476-5589
Practice Address - Fax:660-476-5749
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO25747018OtherBCBS
MOU74426Medicare UPIN
MO0007742Medicare ID - Type Unspecified