Healthcare Provider Details

I. General information

NPI: 1346428620
Provider Name (Legal Business Name): KIMBERLY GERBERS BRENGLE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 DAVENPORT DR STE 200B
FRANKLIN TN
37069-4204
US

IV. Provider business mailing address

1109 DAVENPORT DR STE 200B
FRANKLIN TN
37069-4204
US

V. Phone/Fax

Practice location:
  • Phone: 615-878-3485
  • Fax: 615-878-3485
Mailing address:
  • Phone: 615-878-3485
  • Fax: 615-878-3485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2414
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08002327A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: