Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC36221 | CA |
NPI | 1316698012 |
---|---|
Provider Name | Dr. Cassidy Marie Brown |
First Address | Long Beach, CA 90803-4841 |
Second Address | Long Beach, CA 90803-4841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2022 |
Last Update Date | 13/01/2022 |