Provider Demographics
NPI:1487112629
Name:BRENNAN RICHE D.C.
Entity type:Organization
Organization Name:BRENNAN RICHE D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-359-9853
Mailing Address - Street 1:805 SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-5073
Mailing Address - Country:US
Mailing Address - Phone:318-359-9853
Mailing Address - Fax:
Practice Address - Street 1:1450 HUGHES RD STE 250
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7364
Practice Address - Country:US
Practice Address - Phone:318-359-9853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty