Healthcare Provider Details

I. General information

NPI: 1174691026
Provider Name (Legal Business Name): BRAUN CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 SONORA DR
LILLINGTON NC
27546-6343
US

IV. Provider business mailing address

3132 N GRIMES ST
HOBBS NM
88240
US

V. Phone/Fax

Practice location:
  • Phone: 910-364-1883
  • Fax:
Mailing address:
  • Phone: 505-392-3561
  • Fax: 505-392-4771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1421
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1421
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number1421
License Number StateNM

VIII. Authorized Official

Name: DR. RONALD GLENN BRAUN
Title or Position: PRESIDENT
Credential: DC
Phone: 910-364-1883