Provider Demographics
NPI:1124271358
Name:BROWN, RICHARD L (DC05/09/1940)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC05/09/1940
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 933
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23927-0933
Mailing Address - Country:US
Mailing Address - Phone:434-374-2143
Mailing Address - Fax:434-374-8017
Practice Address - Street 1:914-C VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23927-0933
Practice Address - Country:US
Practice Address - Phone:434-374-2143
Practice Address - Fax:434-374-8017
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000378111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner