Doctor Name: | PAUL BRENNAN |
NPI Number: | 1568891943 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 150 E 300 N Ivins, UT - 847386139 |
Business Phone Number: | 4356328081 |
Business Fax Number: | |
Mailing Address: | 150 E 300 N, IVINS |
State: | UT |
Postal Code: | 847386139 |
Phone Number: | 4356328081 |
Fax Number: | |
NPI Enumeration Date: | 11/05/2013 |
NPI Last Update Date: | 11/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |