Provider Demographics
NPI:1134603798
Name:PLUMMER, BRIAN DAVIS (DC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVIS
Last Name:PLUMMER
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 1:4500 PENNY LN SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49418-8324
Mailing Address - Country:US
Mailing Address - Phone:616-481-5310
Mailing Address - Fax:
Practice Address - Street 1:2603 W MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-4234
Practice Address - Country:US
Practice Address - Phone:009-416-6728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010697111N00000X
OHDC-05281111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor