MEDICARE: WILLIAM JAMES BRENNER MSPT

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	225100000X	Physical Therapist	5501011719	MI

General Provider Information

NPI Number	:	1669432688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM JAMES BRENNER MSPT

Provider Business Mailing Address
First Line	:	33900 HARPER AVE STE 104
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48035-4258
Country	:	US
Telephone Number	:	586-416-9100
Fax Number	:	586-416-9103

Provider Business Practice Location Address
First Line	:	1747 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2948
Country	:	US
Telephone Number	:	734-738-0000
Fax Number	:	734-738-0038

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	04/02/2026

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