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General NPI Number Information
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NPI Number | 1841359874
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Entity Type | Individual
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Provider Name | EDMUND DAVID BRUNDELL DC
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Gender | Male
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9138 BONITA BEACH RD SE
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4291
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Country | US
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Telephone | 239-947-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 900 SW 28TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33914-4295
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Country | US
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Telephone | 239-772-0833
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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 | CH0007368
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License Number State | FL
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