Provider Demographics
NPI:1972687895
Name:BROW, JOHN ROBERT (DC, DACNB, CNS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBERT
Last Name:BROW
Suffix:
Gender:M
Credentials:DC, DACNB, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 LAMBS GAP RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2522
Mailing Address - Country:US
Mailing Address - Phone:717-795-9566
Mailing Address - Fax:717-795-9566
Practice Address - Street 1:310 LAMBS GAP RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2522
Practice Address - Country:US
Practice Address - Phone:717-795-9566
Practice Address - Fax:717-795-9566
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC00468600111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ793865Medicare ID - Type Unspecified
NJ57762Medicare UPIN