Provider Demographics
NPI:1700037660
Name:MIDDLETON, BRETT MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:MICHAEL
Last Name:MIDDLETON
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 1:5155 MEADOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30028-8529
Mailing Address - Country:US
Mailing Address - Phone:404-310-7658
Mailing Address - Fax:204-282-2437
Practice Address - Street 1:1455 OLD MCDONOUGH HWY SE
Practice Address - Street 2:STE C
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-5979
Practice Address - Country:US
Practice Address - Phone:678-210-2225
Practice Address - Fax:678-210-2226
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor