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General NPI Number Information
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NPI Number | 1356179956
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Entity Type | Individual
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Provider Name | BRENNA DILLEY
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Gender | Female
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 161 CENTRAL AVE S
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City | BROOTEN
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State | MN
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Zip | 56316-4748
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Country | US
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Telephone | 507-227-8228
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 62
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City | BROOTEN
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State | MN
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Zip | 56316-0062
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Country | US
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Telephone | 507-227-8228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NP0017X
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Taxonomy Name | Pediatric Chiropractor
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License Number | 6439
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License Number State | MN
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