Provider Demographics
NPI:1558536581
Name:BRANNAN, DAVID TIMOTHY (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:TIMOTHY
Last Name:BRANNAN
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 1:61 BILL WIGINGTON PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-6862
Mailing Address - Country:US
Mailing Address - Phone:706-253-2120
Mailing Address - Fax:706-253-2122
Practice Address - Street 1:61 BILL WIGINGTON PKWY
Practice Address - Street 2:STE 101
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-6862
Practice Address - Country:US
Practice Address - Phone:706-253-2120
Practice Address - Fax:706-253-2122
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8344111N00000X
GACHIR008344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor