Healthcare Provider Details

I. General information

NPI: 1831617877
Provider Name (Legal Business Name): COLE BRENSON TALTON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7196 CRESTWOOD BLVD STE 100
FREDERICK MD
21703-1845
US

IV. Provider business mailing address

7196 CRESTWOOD BLVD STE 100
FREDERICK MD
21703-1845
US

V. Phone/Fax

Practice location:
  • Phone: 301-698-0001
  • Fax:
Mailing address:
  • Phone: 301-698-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH14567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: