MEDICARE: BRUMMERT FAMILY CHIROPRACTIC, LLC

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
1	111N00000X	Chiropractor	DC010774	PA

General Provider Information

NPI Number	:	1548625676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUMMERT FAMILY CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	3051 ENTERPRISE DR
Second Line	:
City	:	STATE COLLEGE
State	:	PA
Zip	:	16801-2756
Country	:	US
Telephone Number	:	814-777-1558
Fax Number	:

Provider Business Practice Location Address
First Line	:	3051 ENTERPRISE DR
Second Line	:
City	:	STATE COLLEGE
State	:	PA
Zip	:	16801-2756
Country	:	US
Telephone Number	:	814-777-1558
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CRAIG DANIEL BRUMMERT
Credential	:	D.C.
Telephone Number	:	814-777-1558

Provider Enumeration Date	:	12/16/2015
Last Update Date	:	01/20/2016

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