Provider Demographics
NPI:1881694859
Name:BROWN, ROBERT D (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2422 E WASHINGTON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4478
Mailing Address - Country:US
Mailing Address - Phone:309-663-9900
Mailing Address - Fax:309-663-9901
Practice Address - Street 1:2422 E WASHINGTON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4478
Practice Address - Country:US
Practice Address - Phone:309-663-9900
Practice Address - Fax:309-663-9901
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL038-009333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor