Healthcare Provider Details

I. General information

NPI: 1730019894
Provider Name (Legal Business Name): BRENNAN ANTHONY JAMES STAPLETON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4245 JOHNS CREEK PKWY STE A
SUWANEE GA
30024-9122
US

IV. Provider business mailing address

5310 FALLS DR APT 6215
CUMMING GA
30028-3558
US

V. Phone/Fax

Practice location:
  • Phone: 470-309-7511
  • Fax:
Mailing address:
  • Phone: 470-309-7511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR066509
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: