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Individual

MRS. MARYANN BRENNEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
435 S BURNETT RD, SPRINGFIELD, OH 45505-2717
(937) 325-8796
(937) 325-3640
Mailing address
435 S BURNETT RD, SPRINGFIELD, OH 45505-2717
(937) 325-8796
(937) 325-3640

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A-0451
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000009377
ANTHEM BLUE CROSS
OH
05
2373506
OH
Enumeration date
08/17/2006
Last updated
07/08/2007
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