Provider Demographics
NPI:1861511990
Name:DARROW, BRIAN A (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:A
Last Name:DARROW
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 1:1645 N LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-1515
Mailing Address - Country:US
Mailing Address - Phone:765-482-8077
Mailing Address - Fax:765-482-8078
Practice Address - Street 1:1645 N LEBANON ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-1515
Practice Address - Country:US
Practice Address - Phone:765-482-8077
Practice Address - Fax:765-482-8078
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000848A111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000095773OtherANTHEM #
IN000000095773OtherANTHEM #