Provider Demographics
NPI:1285886580
Name:NORMANDIN, BRENNA SALVATORE (DC)
Entity type:Individual
Prefix:MRS
First Name:BRENNA
Middle Name:SALVATORE
Last Name:NORMANDIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SANBORN ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-3756
Mailing Address - Country:US
Mailing Address - Phone:978-827-0770
Mailing Address - Fax:
Practice Address - Street 1:53 MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHBURNHAM
Practice Address - State:MA
Practice Address - Zip Code:01430-1247
Practice Address - Country:US
Practice Address - Phone:978-827-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3238111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor