MEDICARE: DR. JEANNE THERESA BRENNAN D.C.

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
1	111N00000X	Chiropractor	38MC00308600	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508957259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANNE THERESA BRENNAN D.C.

Provider Business Mailing Address
First Line	:	1212 SHORE RD
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-2446
Country	:	US
Telephone Number	:	609-653-0451
Fax Number	:	609-926-9227

Provider Business Practice Location Address
First Line	:	1212 SHORE RD
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-2446
Country	:	US
Telephone Number	:	609-653-0451
Fax Number	:	609-926-9227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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