Provider Demographics
NPI:1811017098
Name:BRISSEY, RACHEL SKIPPER (DC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SKIPPER
Last Name:BRISSEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 N HARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-8835
Mailing Address - Country:US
Mailing Address - Phone:912-638-9600
Mailing Address - Fax:
Practice Address - Street 1:112 N HARRINGTON RD
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-8835
Practice Address - Country:US
Practice Address - Phone:912-638-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO02439111N00000X
FLCH4946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCCCXMedicare UPIN