Provider Demographics
NPI:1679584825
Name:JENKINS, BRANDON N (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:N
Last Name:JENKINS
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 1:113 TERESA DR
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138
Mailing Address - Country:US
Mailing Address - Phone:615-847-3894
Mailing Address - Fax:615-868-8345
Practice Address - Street 1:110 GLANCY ST
Practice Address - Street 2:SUITE 102
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2326
Practice Address - Country:US
Practice Address - Phone:615-868-7676
Practice Address - Fax:615-868-8345
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC2140111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition