MEDICARE: DR. ROBERT ERIC BRENNAN D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC010989	PA

General Provider Information

NPI Number	:	1356730261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT ERIC BRENNAN D.C

Provider Business Mailing Address
First Line	:	992 OLD EAGLE SCHOOL RD
Second Line	:	SUITE 902
City	:	WAYNE
State	:	PA
Zip	:	19087-1803
Country	:	US
Telephone Number	:	610-337-7463
Fax Number	:

Provider Business Practice Location Address
First Line	:	992 OLD EAGLE SCHOOL RD
Second Line	:	SUITE 902
City	:	WAYNE
State	:	PA
Zip	:	19087-1803
Country	:	US
Telephone Number	:	610-337-7463
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2015
Last Update Date	:	11/04/2016

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