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NPI Code Detail

MEDICARE: TROY E BRUESEWITZ DC

MEDICARE:   TROY E BRUESEWITZ  DC
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
1111N00000XChiropractor3840-012WI

General Provider Information

NPI Number : 1912075912
Entity Type Code : Individual
Provider Name (Legal Business Name) : TROY E BRUESEWITZ DC
Provider Business Mailing Address
First Line : 925 MILWAUKEE AVE.
Second Line : SUITE A
City : BURLINGTON
State : WI
Zip : 53105-1351
Country : US
Telephone Number : 262-763-5800
Fax Number : 262-763-5815
Provider Business Practice Location Address
First Line : 925 MILWAUKEE AVE.
Second Line : SUITE A
City : BURLINGTON
State : WI
Zip : 53105-1351
Country : US
Telephone Number : 262-763-5800
Fax Number : 262-763-5815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 07/08/2007

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Directions to “ TROY E BRUESEWITZ DC” Practice Location

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