Provider Demographics
NPI:1396786190
Name:BROWN CHIROPRACTIC & ACUPUNCTURE, PC
Entity type:Organization
Organization Name:BROWN CHIROPRACTIC & ACUPUNCTURE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-377-1226
Mailing Address - Street 1:3451 SOUTH MERCY ROAD
Mailing Address - Street 2:STE #101
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0206
Mailing Address - Country:US
Mailing Address - Phone:480-377-1226
Mailing Address - Fax:480-377-1228
Practice Address - Street 1:1772 E BOSTON ST STE 107
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-6243
Practice Address - Country:US
Practice Address - Phone:480-377-1226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU58853Medicare UPIN
AZZ69687Medicare ID - Type Unspecified