Provider Demographics
NPI:1245348572
Name:BROWN, LORI CAROL (DC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:CAROL
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:CAROL
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:201 W SWITZLER STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CENTRALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65240
Mailing Address - Country:US
Mailing Address - Phone:573-682-5864
Mailing Address - Fax:573-682-1544
Practice Address - Street 1:201 W SWITZLER STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:CENTRALIA
Practice Address - State:MO
Practice Address - Zip Code:65240
Practice Address - Country:US
Practice Address - Phone:573-682-5864
Practice Address - Fax:573-682-1544
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODD9062OtherRAILROAD MEDICARE PALMETT
691497OtherACN GROUP UNITED HEALTH C
MO200302OtherBC/BS
714796OtherHEALTHLINK