Individual
LARRY BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1593 BRICKYARD RD, CHIPLEY, FL 32428-5954
(850) 596-1399
Mailing address
1593 BRICKYARD RD, CHIPLEY, FL 32428-5954
(850) 596-1399
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
12/30/2015
Last updated
12/30/2015
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