Healthcare Provider Details

I. General information

NPI: 1134127731
Provider Name (Legal Business Name): BONNIE ZSCHUNKE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 04/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 FEDERAL RD UNIT #18
BROOKFIELD CT
06804-2041
US

IV. Provider business mailing address

499 FEDERAL RD UNIT #18
BROOKFIELD CT
06804-2041
US

V. Phone/Fax

Practice location:
  • Phone: 203-775-7102
  • Fax: 203-775-6843
Mailing address:
  • Phone: 203-775-7102
  • Fax: 203-775-6843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number001363
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX009471-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: