Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 8014253-1202 | UT |
N | 111NR0400X | Rehabilitation Chiropractor | CH60205190 | WA |
NPI | 1154628865 |
---|---|
Provider Name | Dr. Eric Randall Brown |
First Address | Salt Lake City, UT 84124-1491 |
Second Address | Salt Lake City, UT 84106-2522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2011 |
Last Update Date | 25/10/2019 |