Provider Demographics
NPI:1871659649
Name:BROWN, CARYN LYN (DC)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:LYN
Last Name:BROWN
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 1:740 ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-5005
Mailing Address - Country:US
Mailing Address - Phone:417-726-5144
Mailing Address - Fax:177-265-1444
Practice Address - Street 1:740 ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-5005
Practice Address - Country:US
Practice Address - Phone:417-726-5144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3337111N00000X
MO2011005612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty