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General NPI Number Information
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NPI Number | 1134413420
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Entity Type | Individual
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Provider Name | PHILIP JOHN BRUNTON D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2011
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 12082 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-7371
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Country | US
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Telephone | 352-684-2707
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Fax |
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Provider Business Mailing Address
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Address Line | 14367 SALTBY PL.
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City | SPRING HILL
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State | FL
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Zip | 34609
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Country | US
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Telephone | 862-368-3342
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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 | CH10309
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License Number State | FL
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