MEDICARE: BRENNAN CHIROPRACTIC

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	305R00000X	Preferred Provider Organization	4061	OR

General Provider Information

NPI Number	:	1447633482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRENNAN CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1497 LANCASTER DR NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-1961
Country	:	US
Telephone Number	:	352-222-9280
Fax Number	:	503-589-1155

Provider Business Practice Location Address
First Line	:	1497 LANCASTER DR NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-1961
Country	:	US
Telephone Number	:	352-222-9280
Fax Number	:	503-589-1155

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. KRISTEN ANNE BRENNAN
Credential	:	D.C.
Telephone Number	:	352-222-9280

Provider Enumeration Date	:	07/08/2015
Last Update Date	:	07/08/2015

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Directions to “BRENNAN CHIROPRACTIC ” Practice Location

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