Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5874 | MO |
NPI | 1013014182 |
---|---|
Provider Name | Dr. Joan Lorrie Brower |
First Address | Wentzville, MO 63385-1170 |
Second Address | Wentzville, MO 63385-1170 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 29/10/2013 |