Provider Demographics
NPI:1457012494
Name:BLUEMEL, BRIANA G (DC)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:G
Last Name:BLUEMEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 CHUCK DAWLEY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7303
Mailing Address - Country:US
Mailing Address - Phone:646-894-5767
Mailing Address - Fax:
Practice Address - Street 1:1311 CHUCK DAWLEY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7303
Practice Address - Country:US
Practice Address - Phone:646-894-5767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4977OtherSC STATE BORD