Provider Demographics
NPI:1225380280
Name:O'NEIL, BRENDA COLLEEN (DC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:COLLEEN
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 HARNETT CT STE B
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2067
Mailing Address - Country:US
Mailing Address - Phone:931-919-3225
Mailing Address - Fax:931-919-2967
Practice Address - Street 1:204 HARNETT CT STE B
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2067
Practice Address - Country:US
Practice Address - Phone:931-919-3225
Practice Address - Fax:931-919-2967
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor