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Organization

NEW BALANCE LAKE ST. LOUIS

Active
Parent organization
BROWN'S ENTERPRISES
Organization subpart
Yes

Provider details

NPI number
Legal business name
BROWN'S ENTERPRISES
Authorized official
MR. CHAD LOUIS BROWN C.PED (CERTIFIED PEDORTHIST)
(636) 561-2204
Entity
Organization

Contact information

Practice address
21 MEADOWS CIRCLE DR, SUITE 314, LAKE ST LOUIS, MO 63367-4109
(636) 561-2204
(636) 625-2611
Mailing address
21 MEADOWS CIRCLE DR, SUITE 314, LAKE ST LOUIS, MO 63367-4109
(636) 561-2204
(636) 625-2611

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
013370
MO

Other

Enumeration date
01/28/2009
Last updated
01/28/2009
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