Provider Demographics
NPI:1336973890
Name:BRANTNER SPORTS CHIROPRACTIC, APC
Entity type:Organization
Organization Name:BRANTNER SPORTS CHIROPRACTIC, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-563-1655
Mailing Address - Street 1:3727 BUCHANAN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-1779
Mailing Address - Country:US
Mailing Address - Phone:415-563-1655
Mailing Address - Fax:
Practice Address - Street 1:3727 BUCHANAN ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-1779
Practice Address - Country:US
Practice Address - Phone:415-563-1655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty