Provider Demographics
NPI:1811923626
Name:SALMINEN, BRYAN JEFFREY (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:JEFFREY
Last Name:SALMINEN
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 1:12220 BIRMINGHAM HWY
Mailing Address - Street 2:SUITE 40
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4186
Mailing Address - Country:US
Mailing Address - Phone:770-752-0085
Mailing Address - Fax:
Practice Address - Street 1:12220 BIRMINGHAM HWY
Practice Address - Street 2:SUITE 40
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-4186
Practice Address - Country:US
Practice Address - Phone:770-752-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU77700Medicare UPIN
GA35ZCFTBMedicare ID - Type UnspecifiedCURRENT MEDICARE ID #