Provider Demographics
NPI:1538192943
Name:KANTNER-BRENINGHOUSE, EMILY SUZANNE (DC DOCTOR OF CHIROPR)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUZANNE
Last Name:KANTNER-BRENINGHOUSE
Suffix:
Gender:F
Credentials:DC DOCTOR OF CHIROPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020
Mailing Address - Country:US
Mailing Address - Phone:215-891-9955
Mailing Address - Fax:215-891-9655
Practice Address - Street 1:2440 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-891-9955
Practice Address - Fax:215-891-9655
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007588L111N00000X
FLCH7688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U77254Medicare UPIN
PA032019Medicare ID - Type Unspecified