Individual
JOSEPH DALE BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 SAINT ANTOINE ST # 9C, DETROIT, MI 48201-2153
(313) 745-5146
Mailing address
11706 PLYMOUTH WOODS DR, LIVONIA, MI 48150-4507
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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