Provider Demographics
NPI:1629367701
Name:BRANTNER, ZACHARY J (DC)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:J
Last Name:BRANTNER
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 1:3727 BUCHANAN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-5410
Mailing Address - Country:US
Mailing Address - Phone:415-563-1655
Mailing Address - Fax:415-563-1697
Practice Address - Street 1:3727 BUCHANAN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-5410
Practice Address - Country:US
Practice Address - Phone:415-563-1655
Practice Address - Fax:415-563-1697
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31960111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor