Provider Demographics
NPI:1457724494
Name:BROWN, GREGORY KENT JR (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:KENT
Last Name:BROWN
Suffix:JR
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 1:12301 GREENVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-1515
Mailing Address - Country:US
Mailing Address - Phone:864-729-3624
Mailing Address - Fax:
Practice Address - Street 1:12301 GREENVILLE HWY
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-1515
Practice Address - Country:US
Practice Address - Phone:864-729-3624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDC.4038 DC111N00000X
COCHR.0007345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor