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General NPI Number Information
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NPI Number | 1316385909
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Entity Type | Organization
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Legal Business Name | KEITH A BRENNAN DC PLLC
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 45280 CASS AVE
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City | UTICA
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State | MI
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Zip | 48317-5600
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Country | US
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Telephone | 586-254-3303
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Fax | 206-337-9141
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Provider Business Mailing Address
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Address Line | 45280 CASS AVE
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City | UTICA
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State | MI
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Zip | 48317-5600
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Country | US
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Telephone | 586-254-3303
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Fax | 206-337-9141
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEITH A BRENNAN
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Credential | DC
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Telephone | 586-254-3303
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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 | 2301009708
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License Number State | MI
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