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Individual

DR. MARK ANTHONY BRENNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2380 TROOP DRIVE, SUITE 201, SARTELL, MN 56377-4637
(320) 252-5599
(320) 253-4585
Mailing address
2380 TROOP DRIVE, SUITE 201, SARTELL, MN 56377-4637
(320) 252-5599
(320) 253-4585

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
2229
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26817BR
BLUECROSS/BLUE SHIELD
MN
05
808328200
MN
Enumeration date
10/26/2006
Last updated
01/04/2017
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