Healthcare Provider Details

I. General information

NPI: 1114755790
Provider Name (Legal Business Name): BRANDON DANIEL AKI-JACKSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S CAPITAL AVE
ATHENS MI
49011-5102
US

IV. Provider business mailing address

16977 E Y AVE
FULTON MI
49052-9711
US

V. Phone/Fax

Practice location:
  • Phone: 269-924-9463
  • Fax:
Mailing address:
  • Phone: 269-924-9463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301401542
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: