Provider Demographics
NPI:1114755790
Name:AKI-JACKSON, BRANDON DANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:DANIEL
Last Name:AKI-JACKSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1877 N GETTY ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-8563
Mailing Address - Country:US
Mailing Address - Phone:231-744-5200
Mailing Address - Fax:
Practice Address - Street 1:1877 N GETTY ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-8563
Practice Address - Country:US
Practice Address - Phone:231-744-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor