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General NPI Number Information
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NPI Number | 1134311350
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Entity Type | Individual
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Provider Name | PRUDENCE H MUNGER DC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2007
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 526 W GENESEE ST
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City | FRANKENMUTH
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State | MI
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Zip | 48734-1357
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Country | US
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Telephone | 810-280-6641
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Fax |
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Provider Business Mailing Address
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Address Line | 2034 ALGONAC DR
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City | FLINT
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State | MI
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Zip | 48532-4505
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Country | US
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Telephone | 810-280-6641
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4219
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2256
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1814
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5165
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301006150
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License Number State | MI
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