Provider Demographics
NPI:1275351686
Name:BRERETON, DAVIN DARREN ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:DAVIN
Middle Name:DARREN ANTHONY
Last Name:BRERETON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8901 W 101ST TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-4217
Mailing Address - Country:US
Mailing Address - Phone:872-232-6563
Mailing Address - Fax:913-427-5111
Practice Address - Street 1:10880 BENSON DR STE 2350
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1599
Practice Address - Country:US
Practice Address - Phone:913-795-7127
Practice Address - Fax:913-427-5111
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0106361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor