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General NPI Number Information
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NPI Number | 1982416285
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Entity Type | Organization
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Legal Business Name | BREWER CHIROPRACTIC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 2453 TOWNE LAKE PKWY
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City | WOODSTOCK
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State | GA
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Zip | 30189-5525
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Country | US
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Telephone | 770-592-2505
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Fax |
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Provider Business Mailing Address
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Address Line | 204 FOOTHILL DR
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City | WOODSTOCK
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State | GA
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Zip | 30188-2808
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Country | US
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Telephone | 843-224-9929
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | MR. CALEB RYAN BREWER
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Credential | D.C.
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Telephone | 843-224-9929
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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 |
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License Number State |
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