Provider Demographics
NPI:1073949228
Name:COMMERFORD, BRENNAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRENNAN
Middle Name:
Last Name:COMMERFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10628 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1651
Mailing Address - Country:US
Mailing Address - Phone:913-307-0733
Mailing Address - Fax:855-691-8992
Practice Address - Street 1:10628 W 87TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214
Practice Address - Country:US
Practice Address - Phone:913-307-0733
Practice Address - Fax:855-691-8992
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105576111NI0900X
KS01-05576111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0900XChiropractic ProvidersChiropractorInternist