Provider Demographics
NPI:1730404047
Name:ACKERMANN, BRIAN JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAMES
Last Name:ACKERMANN
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 1:22 WEST ROBERT TOOMBS AVE
Mailing Address - Street 2:R
Mailing Address - City:WASHINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30673
Mailing Address - Country:US
Mailing Address - Phone:678-508-1123
Mailing Address - Fax:
Practice Address - Street 1:22 WEST ROBERT TOOMBS AVE
Practice Address - Street 2:R
Practice Address - City:WASHINGTON
Practice Address - State:GA
Practice Address - Zip Code:30673
Practice Address - Country:US
Practice Address - Phone:678-508-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor