Provider Demographics
NPI:1922721828
Name:HEMLICK, BRENNAN P
Entity Type:Individual
Prefix:
First Name:BRENNAN
Middle Name:P
Last Name:HEMLICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N WICKLIFFE CIR APT 35
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2925
Mailing Address - Country:US
Mailing Address - Phone:330-283-5269
Mailing Address - Fax:
Practice Address - Street 1:24723 DETROIT RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2526
Practice Address - Country:US
Practice Address - Phone:440-892-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT020131225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist