Provider Demographics
NPI:1215409149
Name:MERRIWETHER, BRIEANNA
Entity Type:Individual
Prefix:
First Name:BRIEANNA
Middle Name:
Last Name:MERRIWETHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9641 BROOKDALE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8706
Mailing Address - Country:US
Mailing Address - Phone:407-756-5944
Mailing Address - Fax:
Practice Address - Street 1:9641 BROOKDALE DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-8706
Practice Address - Country:US
Practice Address - Phone:407-756-5944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty