NPI 1306388400 · live from the CMS NPI Registry
Brenderlin Health LLC
Podiatrist, Foot & Ankle Surgery in Draper, UT. National Provider Identifier 1306388400, active.
NPI record
| NPI | 1306388400 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 12592 S 150 E, Draper, UT 84020 |
| Practice phone | 713-377-2167 |
| Enumerated | November 7, 2016 |
| Last updated | November 7, 2016 |
| Authorized official | Mark Ellis, Owner/Administrator |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 10105797-0501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.