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General NPI Number Information
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NPI Number | 1982884979
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Entity Type | Organization
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Legal Business Name | BRUNER CHIROPRACTIC HEALTH CENTER, INC
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 516 W CRAWFORD AVE
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-2533
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Country | US
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Telephone | 724-628-8872
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Fax |
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Provider Business Mailing Address
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Address Line | 516 W CRAWFORD AVE
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-2533
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Country | US
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Telephone | 724-628-8872
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CHIROPRACTOR
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Name | DR. MICHAEL TODD BRUNER
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Credential | D.C.
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Telephone | 724-628-8872
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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 | DC006118-L
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License Number State | PA
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