Provider Demographics
NPI:1609854827
Name:MEDINA, BRENDA LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:LEE
Last Name:MEDINA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:330 FRANKLIN RD
Mailing Address - Street 2:SUITE 266B
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3280
Mailing Address - Country:US
Mailing Address - Phone:615-373-7009
Mailing Address - Fax:615-373-7090
Practice Address - Street 1:330 FRANKLIN RD
Practice Address - Street 2:SUITE 266B
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3280
Practice Address - Country:US
Practice Address - Phone:615-373-7009
Practice Address - Fax:615-373-7090
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDC0000002286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor