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NPI Code Detail

MEDICARE: BRUNS CHIROPRACTIC OFFICE SC

MEDICARE: BRUNS CHIROPRACTIC OFFICE SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2500XMedical Specialty Clinic/Center1362-012WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174723084
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRUNS CHIROPRACTIC OFFICE SC
Provider Business Mailing Address
First Line : 1429 NORTH AVE
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53083-4760
Country : US
Telephone Number : 920-458-8252
Fax Number : 920-458-3942
Provider Business Practice Location Address
First Line : 1429 NORTH AVE
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53083-4760
Country : US
Telephone Number : 920-458-8252
Fax Number : 920-458-3942
Authorized Official
Title or Position : CHIROPRACTOR/OWNER
Name : DR. JOHN CLARENCE BRUNS
Credential : DC
Telephone Number : 920-458-8252
Provider Enumeration Date : 07/19/2007
Last Update Date : 07/19/2007

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Directions to “BRUNS CHIROPRACTIC OFFICE SC ” Practice Location

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