Healthcare Provider Details

I. General information

NPI: 1760694780
Provider Name (Legal Business Name): CECILE A. BRUHN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 N PENRYN RD
MANHEIM PA
17545-9326
US

IV. Provider business mailing address

16 N PENRYN RD
MANHEIM PA
17545-9326
US

V. Phone/Fax

Practice location:
  • Phone: 717-665-2550
  • Fax:
Mailing address:
  • Phone: 717-665-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC006527L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2722328000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerIBC PROVIDER ID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: