Healthcare Provider Details

I. General information

NPI: 1619898038
Provider Name (Legal Business Name): BRENNA FLEMING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 ADAMS ST
MILTON MA
02186-4943
US

IV. Provider business mailing address

475 ADAMS ST
MILTON MA
02186-4943
US

V. Phone/Fax

Practice location:
  • Phone: 617-696-8141
  • Fax:
Mailing address:
  • Phone: 617-696-8141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number36749
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: