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General NPI Number Information
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NPI Number | 1891859849
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Entity Type | Organization
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Legal Business Name | BREMEN FAMILY HEALTH AND WELLNESS
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 509 ALABAMA AVE S
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City | BREMEN
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State | GA
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Zip | 30110-2007
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Country | US
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Telephone | 770-537-5555
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Fax | 770-537-0548
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Provider Business Mailing Address
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Address Line | 509 ALABAMA AVE S
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City | BREMEN
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State | GA
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Zip | 30110-2007
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Country | US
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Telephone | 770-537-5555
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Fax | 770-537-0548
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Authorized Official
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Title or Position | CEO
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Name | RALPH J TEMPLETON
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Credential |
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Telephone | 770-537-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2627
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number |
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | RN150905
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License Number State | GA
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