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General NPI Number Information
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NPI Number | 1164662821
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Entity Type | Organization
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Legal Business Name | BRANTINGHAM CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 340 N WESTLAKE BLVD #120
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-7022
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Country | US
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Telephone | 805-379-3752
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Fax | 805-371-6730
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Provider Business Mailing Address
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Address Line | 340 N WESTLAKE BLVD #120
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-7022
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Country | US
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Telephone | 805-379-3752
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Fax | 805-371-6730
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENT JEFFREY BRANTINGHAM
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Credential | D.C., Q.M.E.
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Telephone | 805-379-3752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 23725
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License Number State | CA
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