Provider Demographics
NPI:1558915652
Name:DIAL, BRANDON JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:JAMES
Last Name:DIAL
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 1:2600 TAFT HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-2775
Mailing Address - Country:US
Mailing Address - Phone:423-641-8131
Mailing Address - Fax:
Practice Address - Street 1:2600 TAFT HWY STE 300
Practice Address - Street 2:
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-2775
Practice Address - Country:US
Practice Address - Phone:423-641-8131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-26
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3298111N00000X
WI5471111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor