Provider Demographics
NPI:1275673055
Name:BRAGMAN, ALAN HARRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:HARRIS
Last Name:BRAGMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 ERROL PL NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4869
Mailing Address - Country:US
Mailing Address - Phone:678-777-1161
Mailing Address - Fax:404-255-2029
Practice Address - Street 1:5500 ERROL PL NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4869
Practice Address - Country:US
Practice Address - Phone:678-777-1161
Practice Address - Fax:404-255-2029
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU12843Medicare UPIN