Provider Demographics
NPI:1043934953
Name:BROWN, LANE ELIZABETH POAG (DC)
Entity type:Individual
Prefix:DR
First Name:LANE
Middle Name:ELIZABETH POAG
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4846 DURANT CT
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-0039
Mailing Address - Country:US
Mailing Address - Phone:919-491-9213
Mailing Address - Fax:
Practice Address - Street 1:420 E 15TH ST BLDG B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-3319
Practice Address - Country:US
Practice Address - Phone:980-292-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5546111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor