NPI 1083613848 · live from the CMS NPI Registry
Jordan David Brown, D.O.
Optometrist, Vision Therapy in Salem, OR. National Provider Identifier 1083613848, active.
NPI record
| NPI | 1083613848 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist, Vision Therapy 152WV0400X |
| Practice location | 1097 Liberty St Se, Salem, OR 97302 |
| Practice phone | 503-581-4411 |
| Mailing address | 4165 Andrea Dr Nw, Salem, OR 97304 |
| Enumerated | July 14, 2005 |
| Last updated | November 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist, Vision Therapy primary | 152WV0400X | 1515 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.