MEDICARE: DR. MEAGHAN S BRENT 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	2301009730	MI

General Provider Information

NPI Number	:	1912214982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEAGHAN S BRENT D.C.

Provider Business Mailing Address
First Line	:	6531 WHEATON RD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-7253
Country	:	US
Telephone Number	:	517-812-5629
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 WILDWOOD AVE STE D
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49202-4251
Country	:	US
Telephone Number	:	517-315-4468
Fax Number	:	517-315-4478

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

Provider Enumeration Date	:	09/10/2010
Last Update Date	:	01/15/2020

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