MEDICARE: BRUE CHIROPRACTIC

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	4057	AZ

General Provider Information

NPI Number	:	1619937422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUE CHIROPRACTIC

Provider Business Mailing Address
First Line	:	63701 E SADDLEBROOKE BLVD
Second Line	:	SUITE J
City	:	SADDLEBROOKE
State	:	AZ
Zip	:	85739-1273
Country	:	US
Telephone Number	:	520-825-8182
Fax Number	:	520-825-8192

Provider Business Practice Location Address
First Line	:	63701 E SADDLEBROOKE BLVD
Second Line	:	SUITE J
City	:	SADDLEBROOKE
State	:	AZ
Zip	:	85739-1273
Country	:	US
Telephone Number	:	520-825-8182
Fax Number	:	520-825-8192

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	DR. CRAIG W. BRUE
Credential	:	D.C.
Telephone Number	:	520-825-8182

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	08/22/2020

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Directions to “BRUE CHIROPRACTIC ” Practice Location

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