Healthcare Provider Details

I. General information

NPI: 1952214553
Provider Name (Legal Business Name): BRIJ PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5670 OLD WINDER HWY STE 102
BRASELTON GA
30517-1239
US

IV. Provider business mailing address

203 HEAVENVIEW DR
WALHALLA SC
29691-4002
US

V. Phone/Fax

Practice location:
  • Phone: 470-219-8825
  • Fax:
Mailing address:
  • Phone: 864-784-4945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR066751
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: