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General NPI Number Information
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NPI Number | 1912203456
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Entity Type | Organization
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Legal Business Name | JAMIE L BRENON DC PLLC
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Dates
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Enumeration Date | 02/01/2011
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 1088 BRIGHTON RD
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City | TONAWANDA
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State | NY
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Zip | 14150-8309
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Country | US
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Telephone | 716-837-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 1088 BRIGHTON RD
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City | TONAWANDA
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State | NY
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Zip | 14150-8309
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Country | US
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Telephone | 716-837-1711
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE BRENON
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Credential |
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Telephone | 716-837-1711
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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 | 010040
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License Number State | NY
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