Organization
DANIEL R BROWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL R BROWN DPM (PROVIDER OWNER)
(618) 988-6034
Entity
Organization
Contact information
Practice address
250 SMALL ST, HARRISBURG, IL 62946-3319
(618) 294-8466
(618) 252-2434
Mailing address
101 N 16TH ST, HERRIN, IL 62948-1750
(618) 988-6034
(618) 988-6479
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
016004890
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016004890
MEDICAL LICENSE
IL
Enumeration date
10/08/2014
Last updated
10/17/2014
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