Healthcare Provider Details

I. General information

NPI: 1093765711
Provider Name (Legal Business Name): JAY FREDERICK BRAMMEIER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 5TH ST
DURANT IA
52747-9624
US

IV. Provider business mailing address

109 5TH ST
DURANT IA
52747-9624
US

V. Phone/Fax

Practice location:
  • Phone: 563-785-6336
  • Fax: 563-785-6356
Mailing address:
  • Phone: 563-785-6336
  • Fax: 563-785-6346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberA05311
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2329
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: