Provider Demographics
NPI:1144312976
Name:BROWN, LARRY G (DC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:G
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 1:4530 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-4309
Mailing Address - Country:US
Mailing Address - Phone:202-244-4444
Mailing Address - Fax:202-244-4439
Practice Address - Street 1:4530 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 101
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-4309
Practice Address - Country:US
Practice Address - Phone:202-244-4444
Practice Address - Fax:202-244-4439
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH14656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
154944Medicare ID - Type Unspecified