Individual
JEFFREY GERARD BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
400 E MAIN ST, STE 200, SPRINGPORT, MI 49284-9774
(517) 857-4500
(517) 857-4510
Mailing address
400 E MAIN ST, STE 200, SPRINGPORT, MI 49284-9774
(517) 857-4500
(517) 857-4510
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001774
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601001774
STATE LICENSE
MI
Enumeration date
03/01/2007
Last updated
03/07/2023
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