MEDICARE: DR BETH A BRONEMANN INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376792762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR BETH A BRONEMANN INC

Provider Business Mailing Address
First Line	:	1875 N RIDGE RD E
Second Line	:	STE. A
City	:	LORAIN
State	:	OH
Zip	:	44055-3371
Country	:	US
Telephone Number	:	440-277-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	1875 N RIDGE RD E
Second Line	:	STE. A
City	:	LORAIN
State	:	OH
Zip	:	44055-3371
Country	:	US
Telephone Number	:	440-277-9355
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BETH A BRONEMANN
Credential	:	D.C.
Telephone Number	:	440-277-9355

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	02/03/2009

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Directions to “DR BETH A BRONEMANN INC ” Practice Location

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