Healthcare Provider Details

I. General information

NPI: 1407888480
Provider Name (Legal Business Name): JANET SUE BRUNS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST DEPT OF PM&R
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

3824 BROADVIEW DR
CINCINNATI OH
45208-1948
US

V. Phone/Fax

Practice location:
  • Phone: 513-487-6081
  • Fax: 513-487-6669
Mailing address:
  • Phone: 513-871-0046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35-079781
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: