Provider Demographics
NPI:1619439759
Name:BRENNAN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BRENNAN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-347-9747
Mailing Address - Street 1:229 NW BLUE PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-1800
Mailing Address - Country:US
Mailing Address - Phone:816-347-9747
Mailing Address - Fax:816-347-9748
Practice Address - Street 1:229 NW BLUE PKWY STE C
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-1800
Practice Address - Country:US
Practice Address - Phone:181-634-7974
Practice Address - Fax:816-347-9748
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CURTIS LOUIS BRENNAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000F198Medicaid