Provider Demographics
NPI:1447243761
Name:TOMANEK, BRENDA R (DC)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:R
Last Name:TOMANEK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:R
Other - Last Name:COVETENAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:752 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3133
Mailing Address - Country:US
Mailing Address - Phone:717-699-1661
Mailing Address - Fax:717-699-1662
Practice Address - Street 1:752 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3133
Practice Address - Country:US
Practice Address - Phone:717-699-1661
Practice Address - Fax:717-699-1662
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC00T067L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01664103Medicaid
PA01664103Medicaid
PA003436Medicare ID - Type Unspecified