Provider Demographics
NPI:1992354757
Name:HALES, BRENDEN (DC)
Entity type:Individual
Prefix:DR
First Name:BRENDEN
Middle Name:
Last Name:HALES
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 1:36591 CENTER RIDGE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-2958
Mailing Address - Country:US
Mailing Address - Phone:440-644-0064
Mailing Address - Fax:440-252-0602
Practice Address - Street 1:36591 CENTER RIDGE RD STE 101
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-2958
Practice Address - Country:US
Practice Address - Phone:440-644-0064
Practice Address - Fax:440-252-0602
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor