Individual
MR. CHARLES M BRENNER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4142 S HARVARD, SUITE D 2, TULSA, OK 74135-2617
(918) 745-9123
(918) 712-7457
Mailing address
4142 S HARVARD, SUITE D 2, TULSA, OK 74135-2617
(918) 745-9123
(918) 712-7457
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1763
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731192722001
BCBS
OK
Enumeration date
08/28/2006
Last updated
07/08/2007
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