Provider Demographics
NPI:1891247151
Name:BRENNEMAN, CARLEE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:CARLEE
Middle Name:MARIE
Last Name:BRENNEMAN
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 1:10548 NW 14TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-8093
Mailing Address - Country:US
Mailing Address - Phone:352-214-4987
Mailing Address - Fax:
Practice Address - Street 1:4001 W NEWBERRY RD
Practice Address - Street 2:SUITE B2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2392
Practice Address - Country:US
Practice Address - Phone:352-214-4987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor