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Individual

DANIEL R BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 N 16TH STREET, HERRIN, IL 62948
(618) 988-6034
(618) 988-6479
Mailing address
PO BOX 2025, 101 N 16TH ST, HERRIN, IL 62948-5225
(618) 988-6034
(618) 988-6479

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004890
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016004890
IL
Enumeration date
08/17/2006
Last updated
08/18/2008
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