Provider Demographics
NPI:1447464250
Name:BROWN, DONOVAN R (DC)
Entity type:Individual
Prefix:DR
First Name:DONOVAN
Middle Name:R
Last Name:BROWN
Suffix:
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 1:538 W MIDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4618
Mailing Address - Country:US
Mailing Address - Phone:215-917-6747
Mailing Address - Fax:610-352-5960
Practice Address - Street 1:32 GARRETT RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2303
Practice Address - Country:US
Practice Address - Phone:610-352-8812
Practice Address - Fax:610-352-5960
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009033111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation