Provider Demographics
NPI:1508283649
Name:ABRAMS, BRYAN (DC)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:ABRAMS
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 1:13111 NADINE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1420
Mailing Address - Country:US
Mailing Address - Phone:781-789-8024
Mailing Address - Fax:
Practice Address - Street 1:4050 W MAPLE RD STE 108
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-3118
Practice Address - Country:US
Practice Address - Phone:310-286-0474
Practice Address - Fax:323-922-3283
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31993111N00000X
CADC31993111N00000X
MI2301401293111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor