Provider Demographics
NPI:1154538700
Name:O'CONNOR, BRENDAN PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:PATRICK
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 E DEL RIO DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-3918
Mailing Address - Country:US
Mailing Address - Phone:602-705-4784
Mailing Address - Fax:602-771-6086
Practice Address - Street 1:3540 E BASELINE RD STE 120
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-9628
Practice Address - Country:US
Practice Address - Phone:602-777-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor