Provider Demographics
NPI:1982011623
Name:BRANNON FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BRANNON FAMILY CHIROPRACTIC LLC
Other - Org Name:FAMILY PRACTICE OF CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:BRANNON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:803-609-1806
Mailing Address - Street 1:203 AMICKS FERRY RD STE 800
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-8695
Mailing Address - Country:US
Mailing Address - Phone:803-932-9399
Mailing Address - Fax:803-948-9322
Practice Address - Street 1:203 AMICKS FERRY RD STE 800
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-8695
Practice Address - Country:US
Practice Address - Phone:039-329-3998
Practice Address - Fax:803-948-9322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty