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NPI Code Detail

MEDICARE: BRENDON WHITNEY LLPC

MEDICARE: BRENDON WHITNEY LLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator6401014337MI

General Provider Information

NPI Number : 1134525801
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDON WHITNEY LLPC
Provider Business Mailing Address
First Line : 585 JEWETT RD
Second Line :
City : MASON
State : MI
Zip : 48854-8729
Country : US
Telephone Number : 517-676-5405
Fax Number :
Provider Business Practice Location Address
First Line : 38271 MOUND RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-3401
Country : US
Telephone Number : 586-477-2054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2014
Last Update Date : 11/07/2014

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