Healthcare Provider Details

I. General information

NPI: 1407217755
Provider Name (Legal Business Name): BRUCE CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 N COLUMBUS ST
LANCASTER OH
43130-3033
US

IV. Provider business mailing address

422 N COLUMBUS ST
LANCASTER OH
43130-3033
US

V. Phone/Fax

Practice location:
  • Phone: 740-422-8484
  • Fax: 740-422-8486
Mailing address:
  • Phone: 740-409-2020
  • Fax: 740-422-8486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE BRUCE
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: DC
Phone: 740-422-8484